| Health is a basic human rights, equal access to basic public health service is the foundation for citizens to enjoy their health rights equally. In March of2009, the state council officially published "Suggestions from the state council of the communist party on deepening the reform of medical care system" and " he notice from the state council about printing and distributing the recent key implementation plan (2009-2011) on medical health system reform", and put forward to promote equal access to the basic public health service gradually as one of five important reforms in2009-2011. Rural basic public health service is the main part of the equal access to basic public health service gradually; the research on implementation status and performance evaluation of the public health service project in rural area has certain social value.The purpose of this study is to understand the implementation status and existent difficulties of basic public health service project in rural grassroots in Shandong province, and to analyze the operation condition of its performance assessment, which provides policy advice and reference for the government to improve the basic public health service project.This study based on experts recommend, the level of economic development and capital supporting difference, selects Yiyuan village of Zibo, Shan village of Heze as research sites. The interviews and questionnaire survey on institutions are applied to analyze implementation status and performance evaluation of basic public health service project. Totally2health bureau,2institutions of disease prevention and control,2maternity and child health care organizations,6rural hospitals,16village clinics are investigated. The material analysis methods of this study:(1) by using qualitative analysis software Weft QDA, qualitative interview materials are classified and concluded according to institutions and contents to understand the implementation status and performance evaluation of basic public health service project;(2) descriptive analyzing through the utilization ratio and composition rate the medical services population in rural grassroots, constitute status of human resources, health personnel, professional title, education and age, as well as quantity of9basic public health service project services;(3) analyzing the fairness of the configuration during doctors, nurses, public health officials and technician as well as village doctors by use of lorentz curve and gini coefficient analysis on the basis of population of rural grassroots medical services in2010. The main results of this study:(1)Two different management modes of basic public health service project are applied in the investigated county, namely the department management and classification management mode; the quantity and quality of the completion for9basic public health service project are different, implementations of infectious diseases and vaccination are better; health management of patients with heavy spiritual diseases is in great difficulty. The main reasons which influence the implementation process and quality of basic public health service project can be concluded as follows:poor staff service ability and level, insufficiency of the project funds, imperfect of the information system construction, as well as week consciousness of residents.(2)On the basis of medical services population of rural grassroots in2010, doctors, nurses, public health officials and technicians, and the village doctor’s gini coefficient are0.12,0.19,0.06,0.24and0.25respectively (less than0.3), the configuration is fair. Health personnel service ability in grassroots directly affects the implementation quality of rural basic public health service project. The survey shows that doctors, nurses, public health officials and technicians are mainly with primary title and technical school education, aged between30to39, which is relatively young. Village doctors are mainly with technical school education, skilled in western medicine and lack of professional talents of traditional Chinese medicine, age structure distribution is not reasonable.(3)Basic public health service projects mainly depend on performance evaluation, the purpose of which is to improve the working enthusiasm, initiative and service capacity of health personnel in grassroots, at the same time, made clear the main body and object, exam contents, evaluation time, assessment methods as well as results application. Through the implementation of the performance appraisal, it promotes the implementation of the nine categories of basic public health services project. However, in the implementation process, imperfect performance appraisal, dislocating implementation of the performance assessment of rewards and punishments, and disproportional for the pay and income of the rural grassroots medical institutions and health service personnel are constraint reason for effectively implementing rural basic public health services.Conclusions and Suggestions:(1) applying multiply measures to improve health personnel service ability;(2) constructing funds safeguard mechanism of basic public health service project;(3) promoting process of informatization to improve information management level of basic public health;(4) increasing the propaganda to improve the health consciousness of rural residents and strengthen approval among rural residents;(5) promoting the sustainable development of basic public health service through establishing the assessment mechanism... |
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