| Background:The village doctors in China was a grassroots medical and health care team, it had a huge number and with Chinese characteristics. It produced in a special social and historical environment, rooted in countryside. Village doctors was an indispensable and important force for rural health work in China. But the survival and development of village doctors were facing many challenges, which caused by historical, the new medical reform policies, and urbanization of population and so on.Objective:Be clear on internal and external environmental factors that affect the development of village doctors. SWOT analysis is adopted to make a properly position of the current situation of village doctors. To explore strategies for improve the status of village doctors from two aspects include village doctors’ team and government departments.Methods:The literature analysis method, questionnaire method, focus groups discussions are adopted to acquire the quantitative and qualitative information and data about current situation of village doctors. According to the analysis of information and data, we build a SWOT matrix analysis model to make a reasonable localization of the strengths, weaknesses, opportunities and challenges of village doctors. The SO, ST,WO and WT strategies are put forward to improve the current situation of village doctors on the basis of SWOT analysis.Results:The internal strengths of village doctors were: the medical and health services they provided has positive externality and high availability, there were 74.47 percent of rural residents chose village clinics when they attacked by a general disease. The average working year of village doctors was 27.70±12.64 years, they worked a long time and were familiar with the physical condition and medical history of villagers. They rooted in village areas and met the needs of the village three-level network of medical prevention and health care. The internal weaknesses of village doctors were:the education and professional level of them were low. Education and medical professional education of them were secondary school or equivalent level,accounting for 85.19% and 74.07%. The rate of practicing(assistant) doctors was7.41%, and population aging phenomenon was appearing. The total of village doctors was surplus but the phenomenons of undergo/ off-site were serious.According to the ratio of every 1000 villagers allocated 1.2 village doctor, the rural area of Jiangxi needs 27746 village doctors in theory and there were 21227 more in the book. The survey shows that the rate of undergo/ off-site of village doctors were15.22%. The mind of them was old-fashioned, the diagnosis and treatment they provided was non-standard, and they had poor medical conditions because of low device configuration. The external opportunities of village doctors were: national related departments paid a high attention to village health work. The new medical reform policies were benefit to the development of village doctors and village clinics.The department of New Rural Cooperative Medical System accepted to village clinics. The survey results showed that there was a significant difference between three counties(p<0.05). The Wuyuan County’s rate of chose village clinics when residents attacked by a general disease was lower than Xiushui and Luxi County.The external challenges of village doctors were: the requirement to village doctors was improved but benefits were missing. Policy required 85 percent of village doctors would obtain a practicing(assistant) doctors qualifications, but there were short of appropriate incentives to achieve this goal. Essential drugs zero rate policy had implemented but the complement policy was faultiness. Population urbanization and villagers’ health awareness and demand were increasing. There was a high medical risk but the income and pension level was low. The survey showed that the median income of village doctors was 3 million, the income level was low. The 65 yuan per month elderly village doctors pension allowance was significantly lower than the expectations of them, which was 1551.85±711.10 yuan per month.Conclusion:Under the present economic conditions of our country, the most suitable for rural areas is still village doctors. They have obvious advantages in geographical, contacts and regional culture as well as other aspects, but congenital disadvantages such as aging, low education and professional standards are also obvious. Village doctors are basking in policy turning point, facing both opportunities and challenges. We need to continue deepening medical reform, dominate by the government and agree with the principle of village doctors maximize so as to promote the development of village doctors team. |
PDF Full Text Request