A Study On The Perfection Of Infectious Disease Prevention And Control Management And Surveillance Mechanism In Yunnan Province

Objective: This study focuses on the soundness and related elements of the prevention and control management and monitoring mechanism in the field of infectious diseases in Yunnan Province,and quantifies the current status of the soundness and the trend of changes over the years through the policy text;The impact of the incidence of infectious diseases;by comparing with the appropriate standards of the infectious disease prevention and control mechanism,the gaps are clarified,and the problems and deficiencies of infectious disease prevention and control management and monitoring in Yunnan Province are summarized The countermeasures and suggestions of the monitoring mechanism further promote the improvement of the local level of prevention and control of infectious diseases.Methods: Under the theoretical guidance of the macro model of the health system,the organizational structure,suitable standards and evaluation indicators of the infectious disease prevention system were clarified through the Delphi method.A comprehensive collection ofpublic information published on the official websites of the Yunnan Provincial People's Government,the Provincial Health and Health Commission,and a total of 215 policy documents including laws and regulations,plan planning,notices and announcements.The content analysis method is used to extract key information of the document around the soundness of the management and monitoring mechanism and the field positioning and assignment requirements of its constituent indicators;Excel2010 is used to summarize and analyze the current state of soundness of the prevention and control management and monitoring mechanism for infectious diseases in Yunnan Province,Change;use Spearman correlation analysis to analyze the correlation between the soundness of the management and monitoring mechanism and the incidence of Class A and B infectious diseases in Yunnan Province,and single factor linear regression to analyze the correlation between the two;use the standard gap analysis method to study the reality of the management and control mechanism in Yunnan Province The gap between the situation and the "appropriate standard" explores problems in the construction of management and monitoring mechanisms.Results: 1.The completeness of the prevention and control management and monitoring mechanism for infectious diseases in Yunnan Province increased from 15.58% in 2000 to 28.58% in 2017.The completeness of the management content form is 64.11%.Among the 25 types of content form,16.4 items including short-term goals,tasks and measures,and policy formulation are actually covered.There is a relative lack of 8.6 items such as mid-and long-term goals,department coordination methods,evaluation indicators and standards.The clarification of the division of responsibilities is 32.83%,and the responsibilities of 12.4 departments are mentioned on average.The departments with clear and appreciable responsibilities are only 4.0.They are mainly government,health administrative departments,professional prevention and control agencies,other organizations,key support departments and Most other supporting department responsibilities cannot be assessed.2.The authority of the prevention and control management and monitoring mechanism for infectious diseases in Yunnan Province increased from 26.11% in 2000 to 36.09% in 2017.Among them,the authority level of the person in charge of the government level is 13.80%.Actually,5.4 types of departments can be coordinated,including the provincial government,health administrative departments,disease control centers,medical institutions,and Red Cross;key support departments and most other support departments cannot be coordinated..The authority of the management and monitoring mechanism file set is 72.19%.The release level is mainly the provincial people's government,and there is a relative lack of legislative authority and multi-department joint authorityrelease guarantees.3.The feasibility of the prevention and control management and monitoring mechanism for infectious diseases in Yunnan Province has increased from 15.49% to 16.90%.The infectious disease prevention and control department(institution)'s responsibilities are clearly assessable and the level of assessment subjects has decreased from 11.86% to 9.28%,of which the responsibilities of the major departments are clear and assessable and the assessment subjects have increased from 13.79% to16.68%.Of the 12.4 departments with responsibilities,only 1.6departments set up external assessment bodies on average,including the major business departments in 1.5 categories,which are professional prevention and control institutions.The remaining departments have no assessment bodies,and the responsibilities are difficult to implement effectively.4.On the whole,the soundness of the prevention and control management and monitoring mechanism for infectious diseases in Yunnan Province has increased from 18.97% in 2000 to 27.26% in 2017,including three types of three-level indicators: the completeness and authority of the management and monitoring mechanism The degree of feasibility has increased to varying degrees;the incidence of Class A and B infectious diseases in Yunnan Province has decreased from 278.85 per100,000 in 2002 to 195.04 per 100,000 in 2017.There is a significantnegative correlation between the soundness of management and monitoring mechanisms and the incidence of Class A and B infectious diseases in Yunnan Province.The improvement of soundness affects the decline in the incidence of Class A and B infectious diseases in Yunnan Province.The degree of equation interpretation is 76.1%(P<0.05).Conclusion: At present,the infectious disease prevention and control management and monitoring mechanism in Yunnan Province is still not perfect,the management content form is insufficiently covered,the division of responsibilities of the departments is not clear,the lack of external assessment bodies to supervise,the coordination mechanism lacks legal authority guarantee,and the various dimensions of the elements need to be further improved;The continuous improvement of management and monitoring mechanisms will effectively reduce the incidence of Class A and B infectious diseases in Yunnan Province.To promote the construction of an infectious disease prevention and control system in Yunnan Province,a sound management and monitoring mechanism must be established to improve its comprehensiveness,authority,and implementability.To further cover the form of management content,clarify the division of responsibilities of various departments,improve the task completion standards,form a "cross-regional,cross-department,and cross-border" joint joint coordination mechanism,improve the policy release level,and strengthen the legal authority andbinding force of the management and monitoring mechanism.Accelerate the construction of the monitoring and evaluation mechanism of the prevention and control system,and give a party of the organization system,such as the health administrative department or a third party,the supervision and evaluation function to the remaining participants.In addition,the government should also reasonably expand the scope of concern for infectious diseases,in order to trigger the "switch" for the implementation of prevention and management and monitoring mechanisms to effectively reduce the incidence of infectious diseases.