| Purpose This study is in the view of the health personnel in rural areas in Anhui, collecting and sorting the data of health human resources at town and countryside level throughout the province, describing the quantity and quality character of rural health human resources in Anhui, retrospectively analyzing the features and changing trend of rural health human resources in Anhui province from 2009 to 2013. The article made a prediction of the developing trend of rural health personnel from 2014 to 2020, finding the gap between the present situation of rural human resources disposition and national objectives of health personnel planning. Analyze the main problems that hinder the development of rural human resources from the institutional perspective. Discuss how to train and build a health personnel corresponding to the development of health enterprise of the rural area in Anhui province.Methods The study analyzed the disposition of the quantity and quality of health human resources at town and countryside level and forecasted the future trend of rural health personnel using exponential smoothing method, based on the related data on 2014 China Health Statistics Yearbook, 2014 Anhui Statistical Yearbook and the Anhui provincial health office website. The aspects of deep obstacles analysis conclude dual structure of urban and rural areas, health management system, major health policy and medical education system. With the deep analysis of the strength and weakness of development of rural health personnel in Anhui province, the article aimed to put forward some development strategies corresponding to the situation of health enterprise of Anhui province.Result Firstly, the human resource allocation of township health center remains at low level. Until 2013 the numbers of health technicians, registered(assistant) medical practitioners and registered nurses per thousand rural population of the Anhui township health centers are below the corresponding national average level. Compared with the six central provinces Anhui province ranked behind most of them. The resource allocations of 16 cities of Anhui province do not exist big difference. But the overall resource allocation of each city remains at low level. Secondly, the human resource allocation of village health office remains at low level. Until 2013 the numbers of village doctors, registered(assistant) medical practitioners and registered nurses per thousand rural population of the Anhui province are below the corresponding national average level. Compared with the six central provinces the village doctor allocation of 16 cities of Anhui province remains at low level. Thirdly, township health centers still keep a low doctor-nurse ratio. In recent five years the numbers of registered(assistant) medical practitioners, registered nurses and doctor-nurse ratio of Anhui township health centers have increasing trends generally. But the doctor-nurse ratio is still below the national average level. Fourthly, there are few successors to be the township and village doctors. From 2010 to 2013 the township and village doctor numbers of Anhui province present a slow decreasing trend. The prediction result indicates that the township and village doctor number in 2020 will be significantly less than that in 2013. It reminds that the number of township and village doctors is keeping reduced through natural attrition and transferring. If township and village doctors could not have sufficient reserved forces, they will lack successors. Fifthly, the human resource structure of the township health centers in the investigated region is reasonable. The youth and middle-age doctors occupy the majority of the township health centers. The most doctors have received the secondary vocational school education or above. The doctors that have not received any vocational education just occupy very small ratio. Through recent five year investigation the township health centers do not have a big humanresource flow scale. The staff who entered the centers via unified recruitments occupies 27.2%. And the resigned staff occupies 13.9% of all flow-out staff. Sixthly, the human resource quality of the village health offices in the investigated region stays on a relatively low level. The most village doctors are middle-age and old-age staff. 22 doctors of them are those have reached the retired age, but are still keep working. Most of them have received the secondary vocational school education. 22 of them only have junior high school education experience. The overall education level of the village doctors still remains at low level. The staff who have registered(assistant) medical license in the investigated regions only occupies 26.7%. The professional level of the village doctors is still low. Seventhly, there exists a gap between the health human resource training reality and the training demand in the investigated regions. Some township health centers staff lack veteran retraining. Some village doctors do not reach the national policy request of the training number and the aggregate training time. The gap between the general medical training demand and the reality is the biggest for the township health center staff. Meanwhile, the gap of the clinical skills training is the biggest for the village doctors. Eighthly, the health staff in the investigated regions do not have sufficient satisfaction with their works. The item of payment & bonus is the most dissatisfactory item for the township health center staff. And their satisfactions on the situations of relationship, training effect and personal development are not very high. The items of pension security system and payment income are the most dissatisfactory items for the village doctors. Currently their most urgent demands are the improvements of their payments and pension security level.Discussion and Suggestion1, Deep obstacles analysis for the development of health human resources in rural areas in Anhui: the huge gap between urban and rural impacts the development of health enterprise of the rural area; practitioner accession system for rural health personnelexists a logical paradox; influence on village clinics under the practice of village autonomy in township governance; rural health management system has structural contradiction; the implementation of rural health policy should be improved; government financial policy for rural areas is not reasonable; it is not obvious to see implementation effect of training policy for health personnel in rural areas; lack of specialized education for all levels of the rural health personnel.2, Strength analysis for the development of health human resources in rural areas in Anhui: there is much room for the development of health enterprise in Anhui; the government strongly promotes grassroots health reform.3, Weakness analysis for the development of health human resources in rural areas in Anhui: the level of economic development in Anhui province still belongs to less developed areas; there is a big gap in health resources per capita between Anhui and national level and imbalance in regional distribution.4, Build long-term mechanism for the development of rural health manpower in Anhui province: create a good environment for the introduction of health personnel by the optimization of government investment; further clarify the policy of introducing health personnel and strengthen policy evaluation; establish individualized training methods for rural health manpower; promote the specialization of rural doctors and the determination of their career prospects; set up county hospital, township hospital and village clinic integrated three-level mode; the design of incentive system with the connotation of the township and village health services integration policy. |
PDF Full Text Request