Analysis Of Opportunities And Challenges For Common Gynecological Disease Screening In China

Objective To understand more information of the current situation for common gynecological disease screening among Chinese women;To form the framework of SWOT analysis for common gynecological disease screening;To find out the main factors affecting the implementation of common gynecological disease screening through qualitative and quantitative analysis.Methods This study used the quantitative and qualitative analysis methods,respectively ANP analysis and SWOT analysis to analyze the opportunities and challenges of common gynecological disease screening.By means of literature review,secondary data analysis,field investigation and expert consultation,this study conducted a comprehensive survey of China’s common gynecological disease screening,including its governance,financing,information system,service delivery and health workforce.Descriptive statistical methods were adopted to analyze the quantitative data.The qualitative data were first sorted based on Thematic Framework Analysis,and then analyzed through SWOT analysis to conclude internal strengths and weaknesses and also external opportunities and challenges of common gynecological disease screening.Form the ANP analysis model according to the content of SWOT analysis framework and expert consultation.Then quantify the qualitative results on the basis of assignment for relative importance of each element given by experts to determine the elements’weight and conduct comprehensive analysis.Results 1.Analysis results of the status quo of China’s common gynecological disease screening:1)The screening rate of common gynecological disease screening decreased in 2014,however,from 2014 to 2017,the screening rate was on rise year by year and reached 66.9%in 2017,which was 11.8 percent higher than that in 2014.Regionally,from 2014 to 2017,the east reached higher screening rates than the middle,and the middle than the west.In 2017,the screening rates in east,middle and west regions were 74.6%,63.3%,and 60.2%,respectively.2)In 2017,the provinces with a screening rate between 50%and 80%have the highest proportion in east,middle and west regions.The proportion of provinces with screening rates of less than 50%in the west region is the highest(41.7%).Provinces with screening rates of greater than or equal to 80%had the highest proportion in the east region(36.4%).3)The common gynecological disease screening have various data sources.The cervical cancer and breast cancer screening,and common gynecological disease screening were the main data sources.All provinces have included the cervical cancer and breast cancer screening program as their data sources,however the physical examination data are obviously insufficient.Only 43.33%of provinces have included the physical examination data in their data sources.2.Analysis results of the opportunities and challenges of China’s common gynecological disease screening:1)According to the result of SWOT analysis,at present,the common gynecological disease screening in China has internal strengths and weaknesses,and also external opportunities and challenges.The strengths include the implementation of a number of free screening programs for women health,the continuously increasing coverage of these programs,the well-functioned three-level maternal and child health care service network,and the constant improvement of publicity and education.Weaknesses include the insufficiency of government funds at all levels for common gynecological disease screening,lack of clear regulation,national or local,of screening methods and sources for data collection,lack of standardized management for common gynecological disease screening service system,lack of special programs of common gynecological disease screening,relevant medical workers’ lack of adequate knowledge of screening,and insufficient capacity of primary medical institutions.Opportunities include government’s attention,national or local policy preferences in poor areas,the construction of national and local information platforms,the coverage of various social medical insurance,and the increase of health awareness and health needs of targeted women.challenges include the lack of effective multi-sectoral cooperation mechanism,the poor accessibility of health service,the large mobility of professional and technical personnel in relevant basic medical institutions and insufficient sustainable development of talent team,and the increase of floating population.2)According to the result of ANP analysis,in terms of promoting the implementation of screening for common gynecological diseases,experts believe that internal factors are more important than external factors.Among internal factors,weaknesses are more important than strengths.Among external factors,the opportunities are more important than challenges.The relative importance of the first-level indicators is ranked as weaknesses(0.80)>strengths(0.75)>opportunities(0.25)>challenges(0.20).3)Through the comprehensive analysis of the internal and external factors for the development of the screening,according to the relative importance,the top five second-level indicators is ranked as’The state has launched a number of free programs for women health’(0.304),’Government funds at all levels are insufficient for the screening’(0.300),’The coverage of programs is expanding’(0.211),’lack of regular management’(0.169),and’insufficient development of special programs’(0.149).Conclusion1.Common gynecological disease screening rate increased year by year,but to reach 80%by 2020 as the Development Outline for Chinese Women(2011-2020)proposed,there is still a long way to go.In addition,the screening rate differed regionally and decreased from the east,central region to western region.In 2017,the average screening rate in eastern regions was close to 80%,meanwhile,in the western and middle regions the average screening rates were still around 60%.There is still a big gap.2.The results of this study show that there are both opportunities and challenges in screening work in China.In order to promote the development of screening work,we should seize opportunities,make full use of strengths and develop opportunities while actively facing challenges,overcoming weaknesses and avoiding threats.3.This study comprehensively analyzed the screening status by means of SWOT analysis combined with ANP analysis.SWOT analysis can conduct a comprehensive analysis in the aspect of internal strengths and weaknesses,external opportunity and challenges.On the basis of results of SWOT analysis,ANP analysis could quantify the qualitative data which could directly expresses the factors that should be focus on.Therefore,the combination of SWOT analysis and ANP analysis is a very effective way to analyze the status quo and provide the basis for policy-making.