| BackgroundImmunization program is the plan and strategy that refers to infectious disease prevention and control planning of susceptible population using effective vaccination according to the national immunization program,and to develop the plans to vaccination in the population and prevent and control of specific epidemic diseases with vaccine varieties,there are many factors that affect the vaccination rate of immunization program.There are many researches mainly focused on the investigation and analysis of the vaccination rate of exotic children.However,there are few literatures on immunization providers:the situation of different vaccination clinics and the difference of staff.Therefore,on the basis of previous research.So we focus on the conditions of the hardware configuration,service form and staff of the out-patient vaccination outpatients,study the main factors that affect the national immunization program rate,and provide effective basis for improving the inoculation rate and preventing infectious diseases.ObjectiveThrough the annual report and fund statistics report of Weifang city and urban counties in 2016,to understand the construction status of vaccination clinics in urban and rural areas,to prevent differences of vaccination clinics services between urban and rural,to provide a basis for improving the effective intervention measures,so as to improve the vaccination rate of vaccination clinics,and build a strong immune barrier,popular the prevention of infectious disease outbreaks.Specific objectives:Our study was to understand basic situation of preventive vaccination clinics of Weifang city and urban counties,including outpatient service types,service forms and service radius;to understand vaccination outpatient service personnel of Weifang city and urban counties,including service personnel quantity,age distribution,work experience,education,job title distribution;to understanding preventive vaccination outpatient service coverage rate of Weifang City and urban counties;to find out and analyze the factors of vaccination rate of national immunization in Weifang city;and provide improvement programme on immunization rate measures.MethodWe used the census method and collected the clinic types,service forms,the number of service personnel,age,work experience,education,job title,service population,the number of births last year and eight inoculation rate and other data,and service radius of urban counties vaccination clinics of Weifang city in 2016,and analyze the differences of each index of descriptive.And further study on the impact of each index on the vaccination rate.The datas are from annual population data of vaccination clinic undertaking vaccination tasks:the total populationto,the number of children below 14 years old,the birth rate and the immunization unit basic information.All 2-3 year old children in the outpatient department of Weifang were listed as the research subjects,that is children born in January 1,2014-December 31st 2014.All data are collected and recorded with Excel table,and the error of data is checked.The data are analyzed with Excel and SPSS20.0.The indicators of constituent ratio,rate and so on were used for statistical description.Chi square test was used for statistical analysis.The test level was set to 0.05.Results1.There were 199 vaccination outpatients in 16 counties and cities in Weifang.There are 38 vaccination clinics in the city,accounting for 19.10%of all the vaccination clinics,and 161 out of town vaccination clinics,accounting for 90.90%of all the vaccination clinics.2.In 2016,the total vaccination rate of eight kinds of immunization program vaccine for children aged 2-3 years in Weifang was 86.09%,the highest vaccination rate in Fangzi area was 91.23%,and the lowest vaccination rate in Linqu was 80.16%.The total vaccination rate of eight immunization program vaccines for children aged 2-3 years in the city is 86.47%,while the eight vaccination programs for 2-3 years old children are 2-3.The vaccination rate of eight kinds of immunization program vaccine for 2-3 years old children in urban vaccination clinic is higher than that in township vaccination clinic.There is a difference in vaccination rate between urban and rural vaccination clinic(x2=10.73,P<0.01).3.There are differences in vaccination rate between urban and rural vaccination clinic by the management of township hospitals and community health service centers and more than two-level medical institutions(?2=41.18,84.39,41.23,P<0.01);qualified and digital level of urban and rural vaccination clinic vaccination rate difference was statistically significant(?2=236.50,P<0.01;?2=5.73,P<0.05);the opening of daily vaccination clinic of the urban and rural vaccination rate difference was statistically significant(?2=48.99,P<0.01);the service radius of 5 km and 5-10 km of urban and rural areas following vaccination clinic vaccination rate difference was statistically significant(x2=62.63,43.60,P<0.01);the staff in 5-10 and 10-15 of the urban and rural preventive vaccination clinic vaccination rate difference was statistical significance(?2=26.77,7.78,P<0.01);the number of births in the following 500 people,1000-1500 people and more than 1500 people in urban and rural areas of outpatient vaccination rate difference was statistically significant(x2=4.04,P<0.05;?2=23.89,92.21,P<0.01).4.In general,in 2016,there were 1164 people in the 199 outpatient department reported in Weifang.The largest number of staff in the vaccination clinic were 132 people in Anqiu and Gaomi,and the average number of staff in the county was Gaomi,with an average of 11 staff in each vaccination clinic.City vaccination clinic has a staff of 382 people,accounting for the total number of staff 32.82%outpatient preventive vaccination clinics;Township by staff of 782 people,accounting for the total number of preventive outpatient service staff of 67.18%;urban average vaccination clinic staff of 26.5 people;the township average vaccination clinic staff of 7.9 people;vaccination the staff age ranged from 30?40 years old,a total staff of 393 people,accounting for 33.76%of the total number of staff,city vaccination clinic staff were most in age 20?30 years old,a total staff of 129 people,accounting for the total number of staff 11.08%outpatient preventive vaccination clinics;Township staff maximum age distribution in 30?40,a total staff of 277 people,accounting for the total number of staff of the 23.80%.The staff of outpatient prevention vaccination clinics in urban and rural are with college degree at most,respectively,with a staff of 229 people and 354 people,accounted for 19.67%of the total and 30.41%staff;vaccination staff have no titles at most,a total staff of 373 people,accounting for 32.04%of the total number of staff,vaccination staff with titles have physician at most,a total staff of 320 people,accounting for 27.49%of the total number of staff,including city vaccination clinic staff for the title,a total staff of 167 people,accounting for 14.35%of the total number of staff;the vaccination clinic staff for physicians,a total staff of 246 people,accounting for the total number of staff 21.13%.5.The vaccination rate of the number of children born in the previous year less than 500 and more than 1500 is higher than the average.However,the number of children born in the rural area is increasing.The annual number of children born more than 1500 City vaccination clinics although vaccination rate is higher than the average level,but because the city average vaccination clinic staff number is far greater than the rural vaccination clinics,increased staff,and can reduce workload,improve the quality of work,but by the restrictions of vaccination clinic housing area,inoculation quantity and other hardware devices,after the number of children born in the year reached a certain limit,the workload will be increased exponentially,the inoculation rate of not with the number of staff is also maintained at a certain level but will be greatly reduced6.From the perspective of urban and rural vaccination clinics city vaccination rate of Weifang in 2016,highest vaccination rates are from community health service management of vaccination clinics,vaccination clinics,demonstration by ten days open vaccination clinics,service radius is less than the number of vaccination clinics,serving a population of 5 kilometers less than 20 thousand of the vaccination clinic;the number of staff in different clinics have certain effects on the vaccination rate,but the difference is not too big.The vaccination rate of outpatient vaccination in urban areas was different because of the different levels of out-patient vaccination,service radius and the number of children born in the previous year.The number of births,service radius and outpatient types of out-patient vaccination were statistically significant(P<0.1).The vaccination rate in the township prevention vaccination outpatient was different because of the different types of management units,service radius and the number of open days.There was a statistical significance(P<0.1)for the difference of the management unit type,service radius and the number of open days to the vaccination outpatient of the township.7.Since vaccination is an important part of basic public health work,we should closely follow the division of basic public health work area and vigorously implement the vaccination clinic in community health service institutions.7.As an important part of basic public health work,vaccination should closely follow the division of basic public health work areas throughout the city and vigorously,promote the establishment of vaccination clinics that rely on the management of community health service institutions.8.Means to promote immunization vaccination rate are strengthen the work of management,find out the children's vaccination notice paper base,combined with the telephone,SMS and WeChat notice,take a leak replant means,can effectively improve the immunization vaccination rate,but this can not be purely relying on digital means.9.The vaccination service should be provided enough time.But should not engage in the city and township vaccination clinics in the opening hours of the model,the township vaccination clinic by long tradition,combined with the principle of "fair",continue to rely on the open mode by ten days,where appropriate during the summer and winter increased open days,convenient childcare children and students were.The city will begin daily vaccination clinics.Because the city vaccination clinic management of children's parents are weekly work,so the city to carry out the implementation of daily,weekend as far as possible all the clinic,Monday to Friday holiday arrangements.The opening of the city by the week of vaccination clinic at least one day during the weekend10.We should pay attention to the combination of the traditional door-to-door notification mode and the traditional door-to-door notification mode by using information technology.We should focus on different notification methods according to the different service objects.11.The difference of vaccination staff is the main factor leading to the difference of vaccination services between urban and rural areas.Vaccination clinics with service radius exceeding standard requirements can be divided into outpatient departments,new vaccination clinics or village level vaccination stations should be set up to improve service accessibility.Lack of vaccination clinics in rural areas of 5 km radius of service,to further find tow vaccination rates,if necessary through the abolition of the poor quality of the work,the vaccination service enthusiasm is not high the vaccination units merged into the nearby work better in clinic.12.The shortage of health manpower is a common and severe problem for all districts and counties,and the problems existing in the structure of personnel and the shortage of personnel are the problem of coexistence.The service radius of vaccination clinic has the greatest impact on the accessi bility of vaccination services.In order to provide better vaccination services,the staff in the vaccination clinic should be relatively fixed,not less than 5 persons,of whom 3 persons should be vaccinated,and the BCG should be fixed by special person.The outpatient vaccination clinic with insufficient personnel needs to increase the number of staff according to the workload,and the administration of local health care students when necessary.13.Appropriately increase the number of vaccinated persons reply on the daily dose of inoculation.In principle,the daily dose per vaccinated person should not exceed 20 doses/hour.As restricted by vaccination outpatient service,if should be vaccinated children number increased to a certain degree,to further increase the number of staff does not increase the coverage,so in the immunization clinic should consider when setting up service radius,service population and the number of last year's birth children these indicators,rather than simply increasing staff.Suggestions1.Relying on the management of professional institutions to strengthen the construction of the preventive inoculation institutions.2.Improve the performance evaluation scheme and implement the fund guarantee.3.Various measures are taken to improve the vaccination rate.4.To improve the service capacity of the grass-roots unit,further more.5.Speed up the information construction and management of vaccination.6.To establish and improve the three level immunization network,give full play to make the function of net bottom.7.To increase the publicity of vaccination service. |
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