Study On Focus And Countermeasures Of Infectious Disease Prevention And Control In Primary Health Care Institutions

Objective: To understand the current situation of infectious disease prevention and control in primary health care institutions,identify the problems of primary health care institutions in the field of infectious disease prevention and control,analyze the importance and severity of the problems,establish the priority order of the problems,clarify the key problems that should be solved as a priority,and determine the focal point problems,so as to propose targeted countermeasures for the improvement of infectious disease prevention and control capacity in primary health care institutions,and provide scientific reference for the national health administrative departments to formulate policies on primary infectious disease prevention and control in the future.Methods: Firstly,we searched the literature between 2011 and 2021 on three major Chinese search platforms,namely,Zhiwang,Wanfang,and Wipu,through the literature method to analyze and understand the current situation of infectious disease prevention and control in primary health care institutions,to identify the problems of infectious disease prevention and control at the primary level,and to construct a list of problems.Secondly,we conducted expert consultation on the list of problems formulated in this thesis,and used the hierarchical analysis method to rank the importance of the problems.Then,we analyzed the root causes and studied the mechanism of action of the focal problems according to the fish thorn analysis method and the macroscopic model of the health system.Finally,we used the policy research method to propose policy recommendations to address both the symptoms and the root causes of the root problems.Content: 1.Analyzing relevant laws and regulations,policy documents and academic research literature to understand the current situation of infectious disease prevention and control capacity in primary health care institutions in China and to clarify the connotation of infectious disease prevention and control in primary health care institutions in China at present.2.Collecting problems in the field of infectious disease prevention and control in primary health care institutions systematically to construct a problem list.3.Conducting arguments from all sides according to the problem list,clarifying the importance ranking of the problems based on the results of expert consultation;clarifying the severity ranking of the problems based on the literature review index;and clarifying the priority order of the problems based on the comprehensive consideration of importance and severity.4.Identifying key issues in specific areas based on the priority order of solutions,thus clarifying the focus issues and conducting root cause analysis of the focus issues.5.Proposing strategies based on the focus problems to address the symptoms and root causes.Results: According to the prioritization results,the five key issues that should be given priority attention in the field of communicable disease prevention and control in primary health care institutions are: serious brain drain and shortage of personnel in primary health care;poor competence of primary health care personnel;inadequate training of primary health care personnel and outdated training contents;poor quality of communicable disease reporting;insufficient attention to communicable disease prevention and control by the community and primary health care institutions.The concept of emphasizing medicine over prevention and treatment over prevention is serious.The shortage of primary health care personnel is a major problem.The article also examines the root causes and mechanisms of the problems and finds that the root causes are the difficult conditions and heavy workload at the grassroots level,the unreasonable distribution of the remuneration system and the lack of incentive systems,and the insufficient financial input from the government.Suggestions: 1.Optimizing government input,breaking the two lines of income and expenditure at the grassroots level,and thoroughly implementing the "two allowances" to ensure the continuity of infectious disease prevention and treatment.2.Strengthening the management of public project funds,revitalizing sedimentary public health funds,and improving the efficiency of fund use.3.Improving the salary incentive system,establishing the performance-oriented funding mechanism,performance assessment mechanism and fund use management mechanism,and improving the stability of the talent pool.4.Improving the talent guarantee mechanism,and providing safeguards in terms of titles,promotions,pensions,and other aspects to enhance the attractiveness of positions.5.Improving the mechanism for training health personnel,providing systematic training for grass-roots staff,and strengthening the construction of grass-roots general practitioners.