The Research Of Primary Health Workers’ Train-ing In Rural Areas Of Five Provinces After The New Health Care Reform

"Views on the deepening of the medical and health care system reform" issued by the Central Committee of the Communist Party of China and Central Committee and State Council called for that,"Strengthen the construction of medical and health personnel, formulate and implement personnel construction planning, and focus on strengthening the cultivation and training of public health workers, rural health workers, urban community health professional and personnel and nursing staff." At present the rural health workers are with lower educational attainment, poor in business and out of date in expertise, etc. Large quantities of domestic having shown, training and educating them effectively is an effective way to improve their knowledge, skills and service capabilities.Research Objectives:This study aims to systematically analyze the rural health personnel’s training in China, to further explore, after the new health care reform, the problems in the rural health personnel’s training, and the differences between the training carrying out at present and the training which primary health workers need most, and provide technical support and policy basis for future training policies. Specific research objectives include:1. Analyze the opportunity to enhance the technical capacity of the primary health workers in rural areas.2. Analyze the training need of the primary health workers in rural areas.3. Put forward a set of policy recommendations to improve the training effect of the primary health workers in rural areas.Data Resources and Methods: The resources of information come from the special topic on the establishment of health service system and human resources in the primary health institutions, including the investigations of the rural township health centers and village clinics and their personal, and interviews of the related insiders. Sample areas in the special topic are one city and two counties in Jilin Province, Shanxi Province, Shandong Province, Chongqing City and Anhui Province respectively, with a total number of30rural township health centers and151village clinics. The original data we collected was input into Microsoft Access twice, and then we handle them using Microsoft Excel, and analyze the quantitative data by means of SPSS16.0for Windows. The qualitative data was analyzed after the persons who made interviews transform the recording data into text data.The Main Results:1. Most primary health institutions think highly of the personnel training, and they place more emphasis on it after the new health care reform. The majority of primary health workers have little opportunity to training, but they are trained more after the new health care reform. Although there are some problems in the training, such as short of time, lack of practice and training too fast and so on, almost half of the primary health workers consider the training effective. The health workers in the rural township health centers prefer further education, while the health workers in village clinics consider on-the-job training the most appreciate method, and different categories of health workers in the rural township health centers prefer different training methods.2. Most of the rural township health centers and village clinics have staff training and education funding, but there are also24.1%of the rural township health centers and40.2%of village clinics which don’t have. In the rural township health centers that were given lectures by external experts in2010, the lecture contents focused on medical knowledge and skills and nursing, which focused on medical knowledge and skills and preventive health care. The lecture contents also focused on medical knowledge and skills in the rural township health centers which participated in the training organized by prefectural, municipal and provincial health agencies.3. The doctors in the rural township health centers need training of basic clinic skills, emergency aid, medicine, pediatrics and basic clinic knowledge most, but the contents they participated in most in2010were medicine, basic clinic knowledge, basic clinic skills, emergency aid and community management of chronic diseases. The nurses in the rural township health centers need training of community care, psychological care, health education and health promotion, the use of breathing machine and the use technology of monitor most, but the contents they participated in most in2010were basic care, medical care, community care, aseptic operation and clean technology, basic nursing skills and catheterization technology. Preventive care personnel in the rural township health centers need training of health education and health promotion, the management of health information system, epidemiology, child health care and nutrition and food hygiene most, but the contents they participated in most in2010were epidemiology, health education and health promotion, child health care, woman health care and the aged health care. Village doctors need training of pediatrics, basic clinic skills, medicine, emergency aid and surgery, but the contents they participated in most in2010were basic clinic knowledge, basic clinic skills, community management of chronic diseases, health education and health promotion and community treatment of infectious disease.Conclusion and Suggestions:After the new health care reform, the opportunity primary health workers have to participate in the training has improved, and so do the training frequency and time, but there are also some problems in the training. The training demands of different categories of primary health workers are not satisfied, neither. We should put more emphasis on the training of primary health workers, increase financial support, and establish a reasonable comprehensive training funding system. We should select appropriate training workers, take a different approach to training for different categories of primary health workers if conditions allow, increase the frequency and time of training further, solve a series of problems existing in the training gradually, such as lack of time and practice, and establish appropriate assessment and evaluation mechanisms. For training demand of different categories of primary health workers, we should make some appropriate changes to the current training content, in order to meet their demand better.