The Investigation And Appraisal Of Execution Of Basic Public Health Service Projects In Linzi

BACKGROUNDSWith the developing of economy, the progress of society and the improvement of living standards, people pay much more attention to health. Thus, how to control communicable diseases, prevent chronic non-communicable diseases, strengthen the management of maternal, master knowledge of health, improve awareness of prevent diseases, physical examination and so on are all practical problems that being faced by people. So far, the approach to solve these problems is implementation equilization of basic public health service.Since2009, basic public health service projects involving9projects were started in China. The project funding was shared by the finance of the provinces, cities and counties and everyone shared15yuan. In2011, the projects increased to11, and the project funding also added up to25for everyone. The projects and funding in2012are the same with2011. In2013, the projects increased to12, and the project funding also added up to30for everyone. The increasements of projects and funding of basic public health service fully embody the people-oriented concept and the determination for people’s health.The projects were execued by basic medical institution including health clinics in towns and townships, village clinics and community health service centres. The personnel structure, wage and treatment, office conditions will determine quantities and qualities of the projects directly. Above all, this investigation will study the situation of basic public health service projects in Linzi and to assess the effects, advantages and disadvantages. Therefore, we can propose imprvoement measures for the exsiting problems, provide evdences for improvements of the quantities and qualities of the projects, and promote the basic public health service projects in Linzi.METHODSCensus and sample survey were used in this study, we investigated the basic unit case (services, infrastructure, human resources), basic public health services project implementation, project evaluation, the public satisfaction surveys, and the proposed project and the difficulties that exist in the current work and other aspects eight hospitals in the town center and six community of Linzi district using a questionnaire survey. A total of66towns, street clinics and community health service stations were investigated with random sampling method, the contents included staffing, equipment configuration, age education and other aspects of the investigation. We also took face to face interviews people who are responsible for leading in village clinics and community health service stations. The descriptive epidemiology research methods were performed to find the problems in basic public health services and to propose countermeasures.RESULTSThrough the descriptive analysis about basic public health status of the service center, towns and village health clinics, community health centers and community health service stations in Linzi district, the importance of basic public health services work were fully recognized. The projects have been increased annually and more standardized. Public health departments were established in71.42%service centers and towns and village health clinics, and excellent professionals were selected to undertake the work. According the need of the project work, the equipping rate in8hospitals and6community health service center were89.83%and71.71%, respectively. The staff training rate is100%. According with the "National Essential Public Health Service Specification (2011edition)", we carried out11basic public health projects, the project funding were released after strict examination and supervision, Health records managements were gradually improved, the rate was92.06%; penetration of health education services increased, vaccination rates remained above95%. The management of children, pregnant women, the elderly, patients with hypertension, type2diabetes, and severe mental illness, etc. were gradually standardized. The examination rate was81.16%in people aged over65years; the management rate of hypertension, type2diabetes and severe mental illness were58.86%. The disposal of public health emergencies were more scientific. The supervision and co-management of health services got on the right track. The rates of awareness and satisfaction of the masses of basic public health services were86.78%and81.61%, respectively. However, there are still problems including insufficient staff (personnel the in place rate of hygiene college town was72.83%); professional counterparts, aging (the rate of over60year was11.48%), low quality of personnel(technical secondary school and no education accounted for86.07%in village doctor), poor treatment(the intermediate title appointment rate of hospitals and community service center personnel was54.36%), equipment failure, funds may not meet the needs and so on which directly affect the quality and effectiveness of basic public health services work.CONCLUSIONSMedical institutions at all levels has put the basic public health services as a top priority, and put a lot of manpower and material resources. However, as basic public health services are huge projects, new projects and new challenges will appear with the strength of the country. Many problems are still existed in the town center at all levels of hospitals, village clinics and community health service centers and service stations as how to do a good job on the project, the problems are as follows:1A serious shortage of staffs and professionals, low qualifications of staff, and serious health aging in some towns and villages;2An imperfect protection mechanism and serious shortage of funding that can not meet the work requirements. Unified overall planning are lacked and settings are unreasonable in community health service centers and service stations. Thus, the public health project funds cannot meet the needs of the job.3The shortage of infrastructure configuration such as the medical equipment and other promotional equipment configuration impact the effect of the project;4Low salaries and poor treatment influenced the motivation of rural doctors;5The projects were good with better project configuration, personnel and facilities;6The awareness and satisfaction are still need to be improved. PROPOSALS1Expand staffing, establish a sound system of personnel recruitment, and recruit professional counterparts according to the work.2Improve the security system of funding, Government should earmark for hospitals to finance infrastructure and equipment configuration based on population and economic growth, and re-plan a high standard of community health centers and health stations according to an appropriate proportion.3Improve the treatment and solve the pension problem of rural doctors. Improve primary health care institutions of high, intermediate grade proportion.4Strengthen the management and supervision, and promote the work of the entire project.The weak central hospitals, and community service centers should be strengthened the management and guidance.5Through government and a variety of media tools to increase the public awareness and satisfaction. Therefore, the masses will realize the project work associate with their health, and will consciously accept the service.6Accelerate the pace of basic public health services work, supplement primary care personnel, and to improve service quality comprehensively.