| Research backgroundShandong was once one of the provinces where leprosy prevailed in especially and ranked the third in the whole country. 53883 patients had been found totally by the end of 2005. The leprosy dispensary of Shandong was established in 1955 and the preventing and curing network which was composed by province city and county was set up progressively. Under the leadership of party government and hygiene administrative departments, through the active diligent of the leprosy preventing and curing workers for decades, the . prophylactico-therapeutic institutions at all levels made our province achieve the " basically eliminated " goal that the ill rate was lower than 1/100000 in 1994. Though the goal of "basically eliminated "has already been reached, the annual number of the patients who were infected newly in our province has been in a more steady level all the time, The epidemic situation of some counties and cities has even rebounded in recent years, The situation of the leprosy prevention and cure was still severe. According to Ministry of Public Health relevant requirement, we should keep leprosy preventing and curing professional organizations that "the function can't be changed, the team can't be break up, the funds can't be reduced", and continue doing the leprosy prevention and control well, But because the government departments at all levels had a misunderstanding on the " basically eliminate", this can be concluded from that government's financial resources which were put into were reduced, the preventing and curing funds could not meet with the need of work, thus the prophylactico-therapeutic institutions of some cities and counties were merged since 1994. Research objectiveIn order to understand the development trends and current situations of the leprosy prophylactico-therapeutic institutions at all levels of Shandong and offer the referring basis for leprosy prevention and control and hygiene system reform of leprosy prophylactico-therapeutic institutions of the whole province, this paper investigates and analyzes the changing and current situation of the existing leprosy prophylactico-therapeutic institutions at all levels of Shandong from 1985 to 2005.Materials and methodThis research regards the existing leprosy prophylactico-therapeutic institutions at all levels of Shandong as respondents, and the content investigated mainly includes the personnel organization, the area of the working house, the distributed situation of the staff title and school record, the financial allocations, revenue and expenditure situation of the funds, department of working, medical equipment etc. we set up the database after the materials are gathered, employ Excel and SAS9.0 to analyze and study the development changes from 1985 to 2005 and the current situation of 2005 of the leprosy prophylactico-therapeutic institutions at all levels of Shandong.Main result of study1. The Scale of the leprosy prophylactico-therapeutic institutionThe investigation results show: (1) the scale of the provincial leprosy prophylactico-therapeutic institutions increased progressively. (2) The leprosy prophylactico-therapeutic institutions of Qingdao, Zibo, Heze have been cancelled successively at the city level since 1995. The most existing leprosy prophylactico-therapeutic institutions have been increased gradually since 1985, but since the leprosy was basically eliminated in 1994 when county was regarded as the unit, the situation of most organizations has not basically changed. The working house and fixed assets of every organization at city level changed in different degree, especially after 2000. (3) The organization at county level showed a tendency to reduce in quantity and the personnel of the existing organization have not changed greatly. The working houses and fixed assets of the most organizations at county level have not changed much.2. The staff title and school record of the leprosy prophylactico-therapeutic institutionsThe investigation results show: (1) In the organizations at the level of province, the number of the well-educated personnel showed a tendency to increase in overall and especial since the 1990s, the tendency is faster and the portion is increased gradually. (2) The school record of the personnel in leprosy prophylactico-therapeutic institutions at the city level took the specialized middle school and high school as the core; After 1995, The average education of most organizations are slightly promoted, according to the statistics of 2005, there are only 9 personnel with the Master's education at the city level in the whole province. From 1985 to 1995, every organization's personnel's professional title at city level was mainly with the intermediate and elementary as the main fact. After 1995, the vice personnel of high title increased progressively. The portions of different professional title of every organization at city level are relatively big. (3) From 1985 to 1995, the school record of the personnel of the organizations at the level of country took the special secondary school and high school education as the core, after 1995, the number of the personnel with faculty and undergraduate increased gradually. Until 2005, the school record of every organization basically took special secondary school as the core, and the personnel with undergraduate took few. During the period from 1985 to 1994 when the leprosy was basically eliminated, the personnel's professional title of the organization at the level of county was basically primary, after 1995, the intermediate professional title increased gradually, but still mostly elementary.3. The situation of the business launchingThrough investigating: (1) The special funds for leprosy prevention and curing of the Provincial organization was reduced year by year after the leprosy basically was eliminated in 1994, and kept low level in recent years. Provincial organizations can find the Leper through launching clinical work actively and replenish the funds which are used to prevent and control the leprosy to keep preventing and controlling The leprosy continually and steadily. (2) The financial allocations, business income and the expenditure of the skin disease prevention and control organization at the level of city showed a tendency to increase year by year; however the special funds of the skin disease prevention and control appeared unstable, took the tendency to rise from 1985 to 1994 generally and presented the downward trend generally after 1995, there are no special funds yet at present in most units. (3) The financial allocations and the special funds etc of the leprosy prophylactico-therapeutic institutions at the level of county from 1985 to 1995 have kept steady growth. After 1995, the financial allocations of some units dropped year by year, special funds appeared the downward trend generally. Because the development degree of every organization at the level of the county was different, the situation difference of receipts and expenditures of the business were relatively large, the fund is on the rise generally.4. Conclusions and suggestionsFrom 1985 to 1994, the organizations of the leprosy prophylactico-therapeutic institutions at all levels of Shandong were sound, the funds were sufficient, the governments at all levels and the Administrative departments who are responsible for public health paid close attention to the leprosy prevention and control, the organization had been on the rise all the time. By 1994, Shandong reached the "basically eliminated" leprosy standard by counties and cities that Ministry of Public Health issued, because the governments at all levels and the administrative departments who are responsible for the public health had a deviation understanding of the standard, under the situation that the leprosy morbidity has not obviously dropped over the years, the leprosy prophylactico-therapeutic institutions at all levels of the whole province developed Imbalanced, the financial allocations and special funds couldn't be guaranteed, The focal point of work is leant to the partial services in skin disease clinical diagnosing and treating, some organizations at the level of city and country were cancelled in succession, or amalgamated to the local disease controlling institutions. There are only 1 leprosy prophylactico-therapeutic institution at the level of province, 10 institutions at the level of city and 52 institutions at the level of country by 2005. The development of leprosy prophylactico-therapeutic institutions existing at present was extremely uneven, the conditions of provincial and most of organizations at city level were better; the conditions of some at the level of city and most of the organizations at county level were relatively bad, there existed many problems that the school records and the specialized title were low, financial allocations and special funds were unstable, salary and conditions couldn't be guaranteed etc. Combining the states of the existing leprosy prophylactico-therapeutic institutions of units at various levels of our province, this text gives suggestions and Countermeasures on how to establish the leprosy prevention organization and launch the leprosy prevention and control for the responsible department of the government to consult in the reforming course of hygiene system and public institution in the leprosy prophylactico-therapeutic institutions: Further strengthening the leading of the provincial sanitary administrative department, strengthening the duty of the regional government, closing department's cooperation, sounding the prevention and curing system, defining the duties at all levels; steadying the prevention and curing team, implementing leprosy prevention and curing personnel's relevant treatment; devoting more efforts to training, Setting up provincial leprosy and prevention and curing special funds, etc. |
