Research On Health Human Resources Allocation And Its Equity In Maternal And Child Care In Zibo, Shandong Province

Background1. According to the classical economics theory, the market economy mechanism is harmful for solving the impartiality problem and optimization of health resource distribution. 2. In 2000, it was reported by WHO that China ranked 188th in terms of health financing equity, indicating that China was one of the most unfair and unbalanced countries in health resource allocation. As a result, more and more attention had been paid on health resource equity. 3. Recently, research on human resource demand in health care has been increasingly emphasized by many countries. 4. As "health human resources" was the subject of World Health Day in 2006, it has evoked a worldwide attention. 5.It has been gradually approved that maternal and child care is one of the fields in public health. The situation of health human resource already become the bottleneck that restraint the public health development.In this study, evaluation on the allocation equity of health human resource, in Zibo was made. Suggestions in optimizing its distribution in maternal and child care were also proposed.ObjectivesThis study aimed to understand the demographic and geographic equity in human resource allocation in maternal and child care by analyzing its general situation in volume, distribution and structure. Besides, through the comparison with that of disease control and prevention organizations, this study also concentrated on exploring the potential effective methods in optimizing health human resource, and further providing evidence on the health human resource planning program for government. MethodsDescriptive analysis was applied to demonstrate the general situation of health resource allocation in both maternal and child care and disease control and prevention organizations, in which constitutional ratio were used to illustrate the structure of professional position and academic level etc. Lorenz curve and Gini coefficient were adopted to test the demographic and geographic equity in human resource allocation. According to U.N., Gini coefficient lower than 0.2 indicates absolute equity in income; Gini coefficient between 0.2 and 0.3 indicates relative equity in income; Gini coefficient between 0.3 and 0.4 indicates relative rationality in income; Gini coefficient between 0.4 and 0.5 indicates significant discrepancy in income; Gini coefficient greater than 0.6 indicates dramatic discrepancy in income. At present, the Lorenz curve and Gini coefficient are widely used in the study of the equity of organization and human resources allocation in health field.Main resultsWith an increase tendency year by year, the overall health human resource in maternal and child care organization in Zibo is relatively surplus. There is a significant correlation between general allocation and total population at the end of the year. 2. Education structure is irrational. The overall academic level is relatively low. In 2005, the number of workers with graduate study, undergraduate study, junior college study and secondary technical study account for 1.09%, 23.69%, 33.78% and 41.44% respectively. 3. There is a tendency in developing toward advanced professional position. Quality and professional skills of the healthcare professionals are improved year by year. In 2005, The number of workers with senior professional position, middle professional position and junior professional position accounts for 15.56%, 27.68% and 56.76% respectively. 4. Both of the allocation of the overall volume of health human resource and the number of maternal and child care professionals were relative equity with the coefficients lower than 0.35. Besides, demographic equity has been better than geographic equity all over the years. 5. The equity in allocation of the overall volume of health human resource and that of maternal and child care professionals were approximately similar to each other, including the tendency of decline through years. 6. As to the overall volume of health human resource and the number of maternal and child care, both the number of healthcare professionals per 1000 people and per kilometers square increased year by year. They both reached the lowest point in 1996 with the number of 0.162 and 0.307 respectively, and the highest point in 2005 with the number of 0.109 and 0.215. ConclusionsThe health human resource in maternal and child care organization in Zibo experiences surplus volume, generally low quality and irrational structure in academic level and professional position. 2. Compared to that of the disease control and prevention organization, maternal and child care organization sustains smaller proportion of health professionals in the overall human resource, lower academic level and smaller proportion of senior and middle professional positions. 3. All through the years, the overall volume of health human resource and the number of maternal and child care professionals is similar in equity of allocation, in which demographic equity is better than geographic equity.Policy suggestions1. Strengthen the obligation of government and enhance the public health investment. 2. Emphasize research on planning and exploration of health human resource. 3. Encourage revolution human resource and allocation system. Policies should be made to attract high quality human resource. 4. Control the overall volume of the human resource and regulate the structure appropriately. 5. Strengthen the improvement of the capacity and hence enhance the overall quality of the public health professionals.