The Study Of The Central And Western Rural Areas Of Communicable Disease Surveillance And Early Warning Systems Capabilities Assessment And Its Countermeasures

The infectious disease case reporting system was changed from the traditional excel monthly report from bottom level CDC to national CDC into a newly, timely, internet based infectious disease surveillance and early warning system, after the outbreak of SARS in 2004. The infectious diseases surveillance and early warning system has covered 37 kinds of infectious diseases which classified into three levels. It is necessary to access the infectious diseases surveillance and early warning system to improve the system because of the serious global and domestic infectious diseases prevalence.Jiangxi province, Gansu province and Shanxi province the three provinces in Middle Eastern China were chosen as the project area. Quantitative and qualitative researches had been taken place in nine chosen counties three counties in each province to assess the capability of the infectious diseases surveillance and early warning system in the rural areas in Middle Eastern China. Finally, policy suggestions will be given to improve the capability of infectious diseases surveillance and early warning system based on the assessment results.All county level medical care and health organizations have been using the internet based infectious diseases surveillance and early warning system. But, there are still some township hospitals and all village clinics which don't have the access to the internet based infectious diseases surveillance and early warning system and report infectious diseases cases through telephone and reporting cards. Now, the infectious diseases surveillance and early warning system is operating normally and the top three infectious diseases which have the most cases were HBV(4877 cases), tuberculosis(3720 cases) and bacillary dysentery(949 cases) in the nine pilot areas in 2008. However, the infectious diseases surveillance and early warning system is real-time monitoring and warning timely, there are still some problems in the system. First, the omission and delaying case reporting can not be avoided effectively. Second, the early warning system has three bugs which are improper warning threshold, lack of connection with geographic information and lack of timeliness. This makes early warnings'duplication and inaccurate.The results from the research of the organizations and infectious diseases related staff in the infectious diseases surveillance and early warning system has showed that the capability difference among medical staff in county level, town level and village level is very obvious, especially, the difference between county level and town and village level. The inner imbalanced development in the infectious diseases surveillance and early warning system is causing by the insufficient staff, equipment and case reporting awareness of town level and village level medical staff. In the other hand, medical care and health organizations in different areas also have differences which cause the imbalanced external development of infectious diseases surveillance and early warning system.Some problems have been found from the research and some suggestions have been given to solve these problems. First of all, policies need to be made to guarantee the cooperation between different departments when there are some infectious diseases outbreaks. In addition, the reward system for case reporting is crucial for the case reporting timeliness and can avoid some case omission and delaying. Second, increase the allowance of basic level medical care and health workers besides the infectious diseases matching funds. Equal and reasonable public health allowance policies must be made as soon as possible to assure the related payment to the contributions of basic level medical care workers and improve the infectious diseases surveillance and early warning system in rural areas. Furthermore, training program is important for improving the capability of medical staff. And besides traditional training methods, new training method like video teaching can be used to improve the effectiveness and ensure the training coverage rate.Overall, despite the establishment of the infectious diseases surveillance and early warning system, there are still needs of system improvement and enhancement as to respond to different infectious diseases outbreaks and prevalence and ensure people's health. It is hope that the results of this research can provide some support and help to give impetus to the capability construction of the infectious diseases surveillance and early warning system in the rural areas of Middle Eastern China.