| Objective:The study aims to analyze the distribution status and the changes in different periods of immunization units and staff in China,and the average daily workload of immunization staff and its influencing factors,discuss the problems of immunization units and staff,and discuss the immunization units suitable for the development of the new era,which providing theoretical support for immunization program decision-making and management.Methods:We take immunization units and staff as the research objects,the number of people covered,service cycle,service form,service radius and the number of staff,age,education,specialty,professional title,seniority and the number of vaccine doses of national immunization program of 31 provinces(autonomous regions,municipalities directly under the Central Government)and Xinjiang Production and Construction Corps were collected in China in 2020 through cross-sectional surveys by immunization program information management systern.Collect survey or report data of immunization units and staff in different periods in China from 2004 to 2019.And to describe the differences between the indicators and analyze the influencing factors of the average immunization workload per person per day.The information comes from the immunization units that carried out the vaccination work,and the county-level center for disease and control uniformly reported it.All data were collected and recorded with Microsoft Excel 2016,and analyzed with SPSS 26.0.Results:1.There ere 84 063 immunization units in China.Township-level and village-level immunization units each account for 61.18%and 38.82%.The proportion of population served by township-level units,and village immunization units was 95.14%and 4.86%;Units with fixed-site vaccination,fixed-site or household vaccination,and household vaccination service,accounted for 82.93%,16.16%,and 0.91%,and with 93.07%,6.82%,and 0.11%of the population covered,respectively.The number of the units providing daily,weekly or ten-day,monthly,and other periodic immunization service accounting for 40.76%,25.79%,33.28%,and 0.17%,respectively,which population served accounting for 68.07%,24.33%,7.58%,and 0.02%,respectively Among township-level units,urban immunization units with a service radius of more than 5km accounted for 32.03%,and township clinics with a service radius of more than 10km accounted for 37.69%;the median of urban immunization units and township immunization clinics were 4.3 kilometers and 10.0 kilometers.There were a total of 5 559 private units,accounting for 6.61%.This proportion was 4.99%among township-level immunization units,and 9.18%among village-level immunization units2.A total of 231 435 immunization staff in China,of which the township unit was 81.04%and the village unit was 18.96%.The average number of immunization staff per immunization unit was 2.75,of which township unit was 3.64 and the village unit was 1.34.The average number of immunization staff per 10 000 service population was 1.66,of which 1.41 was vaccinated in the township immunization unit and 6.48 in the village immunization unit.The proportion of women among all staff was 74.73%;the age of immunization staff was mainly distributed between 30 and 40 years old,accounting for 33.42%,among which township-level immunization staff were mostly between 30 and 40 years old,accounting for 34.77%,and village-level immunization staff were mostly at the age of 40 to 50,accounting for 36.91%.Education mainly in college and technical secondary school.In terms of professional distribution,51.64%of staff have nursing specialty,followed by clinical medicine professionals accounting for 28.72%,public health professionals accounting for 6.34%.There were 4 698 staff without medical background,accounting for 2.03%.Township-level immunization units accounted for 0.44%of those without a medical background,and village-level units accounted for 8.82%.The proportion of staff with professional title was 78.07%,and that of township and village units was 89.46%and 29.40%,respectively3.Among the immunization units in China,the implementation rate of information management of township units was 94.93%,and that in eastern,central and western regions was 95.50%,98.72%,and 91.52%,respectively.Among the units that implement information management,99.58%of units could accessed the Internet,and the configuration rates of printers,computers was 96.24%and 100.00%,respectively Units with a computer service life of more than 6 years account for 69.57%,and printers with a service life of more than 5 years account for 69.65%.There were a total of 85071 informatization managers in grass-roots immunization units nationwide,28.04%of people did not operate computers or were unskilled.4.29.05%of the immunization units averaged more than 30 doses per staff per day.Implementing informatization,service population,number of staff per 10 000 service population,immunization unit attributes,the district,and service period were factors affecting average vaccination workload per staff per day.For every 10 000 people served,the average vaccination workload increases by 11.07%(?=0.105,95%CI 0.101?0.109).The longer the service period,the greater the per capita daily vaccination workload(weekly or ten-day service:?=0.753,95%CI:0.734?0.773,monthly service?=2.363,95%CI:2.332?2.393,bimonthly service:?=2.949,95%CI:2.425?3.473)Units with less than standard staff had a higher average daily workload per staff(?=1.075,95%CI:1.057?1.093)5.The number of immunization units in China in 2004,2013,2017,and 2020 was 367 820,203 037,141 310,and 84 063,respectively.Compared with 2004,the number of units in townships and villages and household immunization in 2020 decreased by 77.15%,of which the eastern region,central region and western region decreased by 64.36%,88.25%,and 69.28%,respectively.Compared with 2004,by 2020,the number of township-level,village-level,and household immunization units had decreased by 14.29%,83.25%,and 99.35%,respectively.The number of immunization staff in China in 2006,2013,2017,and 2020 was 167 917,173 777,266 968,and 231 435,respectively.The composition of staff in the eastern,central and western regions increased or decreased from 25.85%,33.62%,and 40.53%in 2006 to 31.08%,24.36%,and 44.56%in 2020,respectively.Compared with 2006,by 2020,the composition ratio of immunization staff in township-level and village-level immunization units increased by 49.73%and-49.73%,respectively.There were 3.9,3.8,1.9,and 1.7 immunization staff per 10 000 population in 2006,2013,2017,and 2020,respectively,with 2.7,2.3,1.3,and 1.4 per 10 000 population at the township-level units and 4.9,6.6,6.3,and 6.5 per 10 000 population at the village-level unitsConclusion:1.The proportion of township-level centralized immunization unit was 61.18%in China.The eastern and central region are dominated by township-level centralized immunization units,while the village-level units in the western region still account for a large proportion.The service radius of 32.03%of urban immunization units and 37.69%of township immunization clinics was too large,10.80%of township-level centralized immunization units and 0.36%of village-level immunization units had long service cycles,this units mainly distributed in rural areas and western regions2.There were large regional differences and urban-rural differences in the distribution of immunization staff,and some staff had low education and professional titles3.There were regional differences in the informatization level of the immunization units,and the western region needs to be strengthened.The aging of information equipment was common.The overall quality level of informatization management staff has been improving,but there was still a lack of informatization work ability4.There was a big difference in the average daily vaccination workload per staff 29.05%of the immunization units averaged more than 30 doses per staff per day.For some units,the low staffing ratio and low service frequency result in a large workload and heavy workload.The main factors affecting the daily per capita vaccination workload of staff were the number of service population,the number of staff,and the service cycle5.Great changes had taken place in immunization units and staff in different periods in China,2004 to 2020.Immunization units at the village level have decreased significantly,while that at the township level had remained basically unchanged.The composition of village-level immunization staff had dropped significantly,while the composition of township-level centralized immunization staff had risen substantially.The proportion of units that implement daily vaccination,and weekly or tenth vaccination gradually increases,and the proportion of units that implement township-level centralized vaccination services gradually increase. |
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