| Objective: Through the investigation of the status of the implementation of basic public health services in the sample area,to understand the status and effects of project implementation in some areas,to identify the existing problems,analyze the reasons,and put forward targeted opinions and suggestions in order to provide decision support for further promoting project progress and improving the level of basic public health services.Methods: Before survey design,consult relevant literature,books,policy documents,etc.to understand the status of implementation of basic public health service projects in the country.In the design of the questionnaire,refer to the training manual and service specifications to develop relevant indicators,and conduct expert consultation to determine the participation indicators;Interviews and questionnaires were conducted on the heads of basic public health service projects,the grassroots health workers providing services,and the people receiving services to understand the difficulties and obstacles encountered in the project delivery process,the results achieved,and the satisfaction of the population.The collected data were sorted and analyzed by general descriptive analysis,T test,multiple linear regression and other statistical methods.Results:(1)Funding for basic public health services in the sample areas: L provincial central government subsidies accounted for a relatively small proportion(30.06%),municipal-level and below accounts for a large proportion(44.03%);A-provincial and C-City central financial subsidies accounted for a relatively high proportion,respectively 68.08%,79.05%,the city level and below accounted for a relatively low investment.In 2009-2016,the subsidy standard for basic public health services percapita in the sample area increased from 15 yuan to 45 yuan,a three-fold increase,with an average annual growth rate of 16.99%.(2)The effect of basic public health services in sample areas: the completion rate of the national basic public health service items in L province is 51.00%-99.93%,that in A province is 50.00%-100.00%,and that in C city is 42.37%-100.00%.In the sample areas,the rate of health archives filing was over 80%;the indicators of vaccination were over99%;the rate of standardized management of chronic diseases was over 64.25%;the rate of health management of the elderly was over 64.86%;and the rate of health management of pregnant women and children was over 88.00%.(3)The ability and evaluation of grass-roots health workers engaged in basic public health services in sample areas: 628 grass-roots health workers were investigated by the research team.The top three scores of basic public health service ability in 12 categories of projects were archiving(82.39 points),hypertensive patients management(80.41points)and elderly health management(80.22 points),respectively.Co-management(55.48 points),Chinese medicine health management(56.89 points)and maternal health management(56.71 points).The total score of basic public health service ability of grassroots health workers was 63.44.In terms of work items,among 631 grass-roots health workers,the top three projects are health archives,health management for the elderly and chronic disease management.The proportion of them is 58.3%,39.8% and38.8%,respectively.37.7% of them are engaged in comprehensive management of basic public health services,35.8% of them are engaged in health education.The workload has increased,but it is still affordable.27.1% of the grass-roots health workers think that the workload is too much for them to bear.35% of the respondents answer that the income has increased.58.8% of the respondents think that the income has not changed.(4)Acquisition and satisfaction of basic public health services: A total of 2636 residents were surveyed,including 376 parents of children aged 0-6,117 pregnant and lying-in women,1042 elderly people aged 65 and over,and 1091 patients with chronicdiseases.The results showed that 98.9% of parents of 0-6 years old children answered that their children had received free vaccination service,89.6% of parents answered that their children had received child health education service,97.4% of pregnant and lying-in women had access to maternal manual,health examination and health education activities,25% of pregnant and lying-in women had access to postpartum visiting service,98.1% of the elderly had access to health examination service,and96.3% of the elderly had access to health examination service.Health education services;97.7% of chronic disease patients received health examination services,97.9% of patients received health education activities.Of the 2636 residents,46.9% had 1-2 visits in two weeks,16% had more than 3 visits and 37.2% had 0 visits.Conclusions:The basic public health service projects in the sample area have achieved good results,and the indicators have basically reached the target of the given work tasks of the country in the current year.The target group has higher satisfaction and a higher sense of acquisition.In terms of project funding management,the health administrative departments at all levels have established internal control systems and financial accounting systems for basic public health services,and allocated funds in accordance with the principle of “first appraisal and post-appropriation” to ensure that funds are earmarked;The situation is good.Fund management,quality control,performance appraisal,etc.are all managed by corresponding systems.However,the personnel and equipment of primary health care institutions are relatively insufficient.The basic health workers are weak in some basic public health service projects.Special personnel training should be strengthened.Introduce professional health talents,improve staffing,and stabilize the talent team. |
