Research On Current Situation And Development Strategy Of Guangxi Medical Teams To Africa

BackgroundDispatch medical teams to recipient countries are both the main form of China’s foreign health aid and an important part of South-South cooperation. Over half a century is past from 1963 the first medical team was dispatched to now. The National Meeting of Foreign Aid Medical Work and the 50th Anniversary of Foreign Aid Medical Team Dispatch was held in 2013 called at a new historical starting point to further strengthen and improve the work on medical teams, actively explore the implementation of new policies and initiatives, and effectively mobilize the enthusiasm of the broad masses of medical personnel, to create a new situation. Guangxi has successively sent 18 batches and 10 batches of medical teams to Niger and Comoros, two African French-speaking countries, since 1976 undertake the national task of medical team dispatch, its current situation and development strategies have not yet been studied. This study is the part of "Researche on Summarizing and Evaluating China’s Overseas Health Aid Policies, and National Overseas Health Aid Strategy" the sub-subject of "China UK Global Health Support Programme Output 2:Development Assistance for Health Core Institutions" undertake by China National Health Development Research Center, it aims to explore how the 50th anniversary as an opportunity to further improve the work of Guangxi medical teams to Africa.ObjectivesThis study analyzes the current situation of Guangxi medical teams to Africa focus on several aspects including management mechanism, personnel structure, working and living abroad, major achievements and impact, problems and challenges, and to propose the future development strategy of Guangxi medical teams to Africa combined with the specific circumstances of Guangxi own and the recipient countries and draw on the useful experience at home and abroad, in order to provide a reference for strengthening and improving the Guangxi medical teams work.MethodsIn this study, various methods are used including literature analysis, individual in-depth interviews, focus group interviews, surveys and expert consultation. The object of this study’s 9 interviews and 23 surveys including the managers of the central and local health administrative departments, the relevant hospital administrators, as well as the recently returned 2 batches of expiration of the mandate of Guangxi medical team members, namely the members of 16th and 17th batch of medical team to Niger and the 8th and 9th batch of medical team to Comoros, involving as many stakeholders. Interview outline and questionaire developed by the Department of Global Health of the China National Health Development Research Center. A descriptive statistical analysis method was used for the results of the survey.ResultsQuestionaire1. Basic information of survey object:23 medical team members surveyed includes the medical workers involved in 12 professional divisions, the full-time administrative captain and translators come from 7 prefecture-level city of Nanning, Guilin, Liuzhou, etc. Their workplace covers all 6 medical points of Guangxi medical team in Niger and Comoros. When they sign up,82%aged 35-55 years,56% is the assistant director physician,66% has a bachelor’s degree, 74% come from the first-class hospital, and 57% did not management positions in hospitals.2. Selection and training situation of medical team members:96% of respondents said their own initiative to enroll in medical teams. The first factor to attract the medical team members to Africa is "to enrich the experience of life’ (38%).83% of respondents believe that the overall effect of training is better or very good. Foreign language is the training content most should strengthen (17%).3. Working and living abroad situation of medical team members: respondents go through the adaptation period average 2.02 months after reaching Africa. They work an average of 6.57 hours per day, outpatient visits each week to 97.27, the average duration of admissions per patient was 14.33 minutes, week of surgical volume of 15.73 units times. Sorted according to the number of service people, "Chinese-funded institutions staff" has become the major service object of medical team second only to "recipient ordinary people" The main difficulties and obstacles in work faced by medical team members is "lack of necessary equipment and Equipments, technology and expertise can not display" (27%); the main difficulties and obstacles in life is "poor communications, the network is disconnected or unstable" (14%); and the main safety and health risks is "Disease" (51%), where "malaria" accounted for 37%.4. Capacity-building situation of recipient country:91% of respondents said that the local hospital has medical equipment or instruments donated by China, but only 35% of them teach equipment operation methods to local medical personnel, and enable them to master.48% of respondents said that he has introduced new technology or treatment methods for the local hospital, but only 35% of them teach new technology to local medical personnel, and enables them to be used independently.5. Incentive and assessment situation of medical team members:60% of 20 doctors surveyed said that their income in medical team to Africa than in the domestic average of 111.43%. Among those assessment results as "excellent", 70% said they were convinced the results of the assessment. In contrast, among the assessment result is "qualified" the rate of only 9%, while the assessment result is "not very convincing" or "not convincing" has accounted for 27%, "excellent" and "qualified" difference between the two groups of medical team members with significant statistically (Z=-2.870, P=0.04). This situation prompted the assessment results may not convince the public.45% of doctors surveyed believe that foreign aid experience to help the promotion of their titles, while 20% think of the promotion has been delayed.13 senior titles of doctors (31%) believe that foreign aid experience to make their own medical technology declined, the main reason is "to keep up with domestic knowledge updating", while 23% believe technology has improved.6. Results of evaluation and policy recommendations:92% of members of medical team to Niger said their level of professionalism is recognized by the local doctor, the rate of members of medical team to Comoros is 67%.92% of members of medical team to Niger said their level of professionalism is recognized by local patients, the rate of members of medical team to Comoros is 87.5%. In response to "what measures do you think are the most effective and feasible, from the perspective of improving China’s foreign health aid influence" the question, most people chose the "reconstruction of key specialist or independent treatment center" (19%).Interviews1. Selection and training situation of medical team members:the work of selection of medical team members facing difficulties. At present, the economic attractiveness of foreign aid has been insufficient; each participant enthusiasm is not high. Training of the way to outsource, in which the main form is language training. French language is difficult; the medical team members can only deal with the mastery of basic communication.2. Working and living abroad situation of medical team members:the medical teams facing outstanding management difficulties. Over the years, the management mechanism can not be straightened out, many management body, but who can not control in place. Medical assistance is difficult to directly benefit the people of the recipient countries, did not adequately reflect the nature of assistance.3. The future direction of the medical team:mandate period of two years is too long, but instead one year must be careful. Reconstruction specialist clinic centers to explore innovative ways are good, but must according to local conditions. Medical personnel of recipient country have a strong desire to study in China; the demand should be effectively released. Hospitals and anti-malaria centers built by China in the idle state can not effectively coordinated with medical team, various forms of health assistance need to create synergy, so that a game of chess.ConclusionsThe problems faced by medical teams:relationship between powers and responsibilities of the parties involved has not been straightened out; imperfect working mechanism; inadequate security and humane care treatment for medical team members; lack of capacity building in recipient countries; lack of synergy between dispatch medical teams and other forms of China’s foreign health aid. Moreover, the Challenges faced by medical teams:recipient countries’demand level continues to increase; international competition in the field of assistance has intensified; the task of medical teams to Africa become more complex and difficult with the expansion of China’s strategic interests; and Guangxi is facing its own pressure from the obvious contradiction between supply and demand of medical resources. Guangxi need to further improve the medical teams work:1. To rationalize the relationship between powers and responsibilities of the parties involved, the first is the relationship between central and local, followed by the relationship between government and the public hospitals; 2. To improve medical teams working mechanisms, including the selection and training, team management at abroad, management of drugs and medical devices, and the follow-up management of medical teams after returning.3. To strengthen the medical team member’s security and humane care treatment.4. To innovative approach and content of foreign medical assistance, including explor short-term dispatch, to discover specialist clinic center model, to expand exchanges and cooperation by "please come in" approach, to promote traditional Chinese medicine and ethnic minority medicine in Guangxi, to mobilize and guide private resources to participate in foreign aid.5. To strengthen synergies and complementarities between the various forms of foreign health aid.