Evaluation Of The Implementation Of The Community 12 Traditional Chinese Medicine Appropriate Technology Promotion Program In Shanghai

BackgroundTraditional Chinese Medicine (TCM) appropriate technology service is an important part of community health services. Based on the theory of TCM and directed by the methods, TCM appropriate technology is safe, effective, economic and convenient, which can satisfy the needs of community residents. To strengthen the popularization and application of TCM appropriate technologies, a promotion project consisting of 12 TCM appropriate technologies for communities was launched in Shanghai in 2010.Objective:To evaluate the project of TCM appropriate technologies promotion in communities of Shanghai, and analyze existing problems and weaknesses during the process of promotion and application, so as to put forward strategies to improve the promotion of TCM appropriate technologies.Methods:Analysis of existing material and field investigation were carried out for evaluation. Through stratified cluster sampling,8 districts were randomly chosen from 17 districts of Shanghai firstly. Then,1 or 2 community health service centers were randomly chosen in each district, and the number of the final sample was 15.Major findings:The promotion of TCM appropriate technologies has been listed as the annual performance appraisal target for district health bureau by municipal health bureau and the TCM development office. The promotion model of TCM appropriate technologies, which focuses on the community health service centers to benefit community residents, is summarized as’1+ 18+240’. Therein,’1’represents the municipal promotion base,’18’represents all the 18 district bases and’240’ represents all community health service centers in Shanghai. The rights and duties have been clarified for each level. According to the standards, the subsidy of 700,000 has been allocated to the municipal base and 500,000 for each district base, with the total of 9.7 million for the implementation of financial security.Faculty team has been constructed in each district base with the total number of 194 teachers. The training coverage rate was 92.5%(222/240) among community health service centers of Shanghai.882 health staff for TCM appropriate technology promotion have received training with the training rate of 91.9%. A satisfaction survey has been carried out among 60 health staff receiving training, with an average score of 45.8 out of 50.Among 15 community health service centers, the frequencies for publicity are 1-2 times through news media on average, and 1-2 times per week through disks playing in communities. Besides,900-1500 brochures for TCM appropriate technology promotion have been sent out.The satisfaction survey among 222 patients showed that the top 3 appropriate technologies were shallow needling acupuncture treatment of facial paralysis (90.0%), moxibustion treatment of knee osteoarthritis (88.5%) and point application prevention of chronic respiratory disease (78.3%). The overall satisfaction rate was 72.1% and voluntary advertising rate was 72.8%.The survey among 16 community health service center managers in 15 centers showed that 12 manager (75%) were satisfied with the project, and the satisfaction rate among 83 health staff for promotion was 78.3%. Through the questionnaire investigation, the main obstacles affecting promotion was the lack of incentive system (82.8%), the lack of money (78.8%) and the poor promotion effect of the project (71.7%).However, the survey also showed that there existed some problems of the project listed as follows.1. Most subsidy has been used to construct the base infrastructure instead of the community health service centers. Thus, some community health service center managers reflected the problem of the lack of money.2. Some technologies are not popular in communities, which showed low appropriateness.3. In some places, one health staff learns several appropriate technologies or several same several health staff attend every training, which inevitably will affect the promotion effects.4. Poor promotion effect of TCM appropriate technology results into the fact that a certain number of community residents have no idea whether the promotion project has been carried out or not.Suggestions:1、Broaden sources of funding to promote technologies, and increase funds allocation and policy support for grass-root communities.2、Take actual needs of community health service centers into consideration more when screening appropriate technologies.3、Innovate the training method for appropriating technologies and focus more on training effectiveness.4、Innovative project publicity, and simplify publicity material by considering patients’ actual needs.5、Improve the training of professional talent team of relevant appropriate technologies of TCM.