Research On Training Effect Evaluation And Mechanism Of Rural Health Workers On Chronic Non-communicable Disease

At present, rural health workers have not enough capability to control chronic non-communicable disease, while training and development of the rural health worker capital relates to the mass of the village grass-roots hygiene and the control horizontal of chronic disease. The knowledge capability training on rural health workers is the important invest to village health human resources, is also the key link that raises the ability of the village health personnel to control chronic disease shape. Along with social and economic development, chronic non-communicable disease becomes important impact factors on resident's hygiene health, the village resident served propose higher request to the grass-roots hygiene. So, to train and tap the rural health workers has be paid attention by government and health segment. In 2009, State council prints the note《A particular reform scheme about medicine health system》,which proposes to use three years to train village and town health workers for 36 and 137 times. The purpose lies in improving the troop structure of rural health worker, and turning rural health workers'knowledge skill.WHO provides the technical support and Luxembourg Government provides the funds safeguard to do this research. The objects of research contain all the rural health workers and project training institutions in 8 targeted counties, in which this training item is implemented. Draw lessons from Kirkpatrick pattern from respond level and study level, behavior level and result level, which four dimensions evaluate the effects of training. Simultaneously this research analyzes the organization constitution and the operation pattern about training. We make profits from the enterprise machine-made training mechanism, explore the effective mechanism about ability training and put forward the effective policy proposal.This text is totally divided into five fractions:the lth fraction is for the foreword. Give an account about the back ground meaning and policy environment. Study purpose, the way of thinking, contents and meaning are Proposed. Through effective chronic disease knowledge training and capacity building of the township level and village level health workers, especially through improving knowledge and prevention ability of hypertension and diabetes, summarize training procedures, methods and experience, and generalize the project experience across the province or country.The second part is about the object of study and the method, which elaborate the training appraisal rationale and the training mechanism analysis rationale. The appraisal effect's rationale is revolves the Kirkpatrick model, and reference the indexes from medical department office "Rural health worker On-the-job training Work Appraisal Indicator system". The rationale of training mechanism is studied through Systematic review, which summarizes six characteristics.This third part is the research results of the training, including the analysis of training effect, problems and mechanism. This article describes the results from the followings: 1. training effect in the active layer effect of the village health workers, who were the training receivers, (analysis of effect and their satisfying degree); 2. Training effects in the learning layer(change of the targets'technical ability); 3. Training effect in the behavior layer(change of the targets'work behavior after be trained); 4. Training effect in the results layer(index of the villagers'morbidity); 5. Analysis of the organization and management in the training; 7. Analysis of the main problems and status in the training mechanism.This forth part discusses three main points around methodology, training effect and mechanism. Training effect and exposed problems are as followings:1. The quality problems about the training receivers; 2. The demand and motivation of the training receivers; 3. Evaluation about the trainers and the training contents; 4. Optimization problems of the training methods; 5. Problems in the process of training management; 6 put forward that training is an effective means to strengthen the chronic disease control measures. Discussion about training mechanism:1. Lack of a normalized chronic disease training system; 2. Set up a regular check-up system; 3. Academic leaders help to improving the comprehensive service levels of the grass-roots health staffs.Including and suggestion:1. Establish core ideas of chronic disease training in the health system.2. Select rational training objects, develop the training contents to adapt to the grass-root health workers; 3. Set up chronic disease training system, ensure both the criterions and sustainable in the training.4. Increasing government financial support.5. Set up perfect training accountability mechanism.