Evaluation And Countermeasure Research Of Jining Tuberculosis Control Program

BackgroundTuberculosis(TB) is a chronic infectious disease transmissing through droplet and airborne. The situation of our country is serious for TB cases ranking second in the world, the Party and the Government attach great importance to control TB, actively implement modern TB control strategy, and establish the working mechanism of governmental leadership, departments cooperation and society taking-part-in. A few of TB control programs were implemented to promote the development of TB control, such as World Bank loan program. TB has the highest incidence of infectious diseases in Jining. To strengthen TB control, Jining had implemented several programs.MethodTaking the literature analysis, TOPSIS method and SWOT analysis,to evaluate Jining TB control program and promote the strategy of Jining TB control program development.ObjectiveThis paper analyzes 2007 Jining TB control program funded by the central government public health funding. The main purpose of Jining TB control program is to promote the implementation of , to reduce TB rate of infection, morbidity and mortality, to improve the health level of the whole people. It has 5 work indicators: to implement 100 percent DOTS strategy in counties, to find more than 70 percent new smear-positive TB patients, to cure more than 85 percent new smear-positive TB patients, to cure more than 90 percent new smear-negative TB patients , to find 4316 TB cases. Program lasted for one year. It was funded by the central government transfer payments and the local government counterpart funds, and done by TB control systems. 7 measures were used in the program: to subsidy the medical staff who reported TB cases, to strengthen supervision of TB patients' management, to follow up the information of TB patients, to strengthen the checking-sputum ability of rural hospital, to build the TB epidemic case management information system, to carry out epidemiological investigation of patients' close contacts, to strengthen supervision of TB institutions.ResultJining TB control program achieved expected aim, and got great social and economic benefits. The DOTS strategy implementation covered all the counties; the whole funds was 2.022 million Yuan; 3607 cases of TB patients were discovered, including 2176 new smear-positive cases; 2680 cases were cured. The program promoted equity in health services, protected people keeping health, produced direct benefit over 26 million Yuan and indirect benefit about 300 million Yuan.There were 6 indexes used in Jining TB control program evaluation by TOPSIS method. Evaluation result found: The better were Yanzhou, Jingxiang, and Jiaxiang, while the worse were Qufu, Zoucheng, and Wenshang. Results showed that it's unfair evaluating TB control program based on a single index; comprehensive evaluation using several indexes were able to more objective reflection program quality.For comprehensive analysis Jining TB control program, we used SWOT method. Strengthen: a modern TB control strategy as a guide, a perfect implementation system of TB control institutions, a good external support, effective cooperation mechanism in TB patients management. Weakness: TB control program were unbalanced development in all counties, the distribution of staff was unreasonable in different institutions of TB prevention and control, doctors got low payments in cases management, and rural residents had low knowledge rate about TB. Opportunities: a strong policy support, gradually perfect medical security system, construction of basic health service system, increasing employment pressure of medical student. Threat: increasing flow people, increasing drug resistance in TB, double infection of AIDS and TB.Countermeasure and Suggestion1 .Emphasizing and implementing government responsibility, increasing investment from the central and province government, and carrying out complete policy of free diagnosis and treatment of TB.2.Giving full scope to the role of the basic health service system, carrying out health management and surveillance in TB control program, pursing visited-doctor-with-recommended mode in discovery of cases, and taking cases management.3.Adjusting the way of program funds payment, using medical service voucher, and changing inputing to purchasing. 4.Altering evaluation method, building indicator systems including several indexes in TB control program evaluation, and promoting TB control program development by comprehensive analysis and objective evaluation.