| Objective This study focuses on collecting and organizing current data of health professionals from township hospitals in all cities of Anhui Province after the health care reform. Through combing relevant provincial and national policies and regulations after the reform, the recruitment, training, evaluation, remuneration and promotion of health professionals were summarized in this study. By comparing collected data with current situation, this study investigated the existing problems in human resources of health in township hospital. Effective solutions and strategies were proposed in this study to improve and secure a healthy growth of township health professional team.Methods The number, education background, job-competency and other relevant information of health professionals from Anhui township hospital in 2013 were obtained from China Health Statistics Yearbook, Anhui Statistics Yearbook, the official website of Anhui Department of Health, and the official website of Anhui Bureau of Statistics. Multiphase sampling method was applied in this study: two counties each in southern, central and northern Anhui province were randomly selected. Three township hospitals in each of the counties were randomly selected, including one central and two general hospitals(total n=18). This study was conducted using two data collection systems:(1) individual-based surveys for township professionals; and(2) face-to-face interview for directors of counties’ Health Bureau and presidents of township hosipital respectively. Following aspects were analyzed in these two data collections:(1)general information of township hospital,(2) quantity and structure, training, remuneration and promotion of health professionals team. Current policy in sample townships was compared the collected data in order to find out the main problems in township health professionals team building under health reform, then summarize the main reasons that influence township health professional team building in rural area. Successful experiences in both China and overseas were adapted to suit current situation in Anhui province, proposing some suggestions to improve implementation of township health professionals team building policy.Results In 2013, Anhui province had 1387 township hospitals and 41,770 health professionals. The number of rural licensed/ licensed assistant doctors and registered nurses per 1,000 population were 0.36 and 0.21 respectively. The total number of health professionals in rural northern part was higher than central or southern part, while the number of health professionals per 1,000 was lower than central or southern part in Anhui province. The setup number of health workers’ position in 18 township hospitals was 777, based on demographic ratio(0.953%). The number of actual employed heath workers was 716, 685 were health professionals(88.16%). 74.2% of health professionals had a primary title. Among personnel who hold a medical degree, 8% had a post-secondary degree or above. In 2013,only 6.8% of the professionals had a monthly salary achieved 3,000(CYN) or above., 54.4% of survey respondents were not satisfied with their monthly income, the percentage of survey respondents who were not satisfied with performance assessment result and contents were 9.2% and 7.6%. 11% of the health professionals were not included in the administrative management.Conclusions Compared with current policies, the results from survys and interviews revealed the current situation in team building of health professionals in sample hospitals: ①health workers’ position was put in place, but the structure requires improvement,overall low education and job title in township health professionals; ②difficulties in recruitment for high quality health professionals; ③training opportunities were inceased, but the quality of training need to be improved; ④high satisfaction about performance assessment, but assessment indicators still need to be improved; ⑤low satisfaction about salary and benefit, lack of effective merit system; ⑥ fair promotion opportunity, but failed to reflect actual performance in promotion. Suggestions :(1)Improve personnel management system, authorize hiring health professionals in township hospitals supervised by local health and personnel bureau. Select health professionals who make a long-term commitment in local area by setting up appropriate number of positions, regulating recruitment examination process. At the same time, apply reassignment policy to improve the structure of the team.(2) Standardize health professionals training system. Improve training and recruitment policies as well as personalized support projects to increase the training opportunities for career development.(3)Improve merit system and foster work motivation. Several solutions are proposed here including increasing salary and benefit, improving performance evaluation procedure which marks the distictions among individuals. We should also learn from effective foreign strategies to inspire the work enthusiasm to a great extent. In addition, we need to strengthen professional title promotion system, create more career development opportunities. Through self-improvement, elevated work motivation by self-recognition, township health professional would have more opportunities to revieve a professional title promotion and get a better career development, therefore stabilizing the team building. |
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