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A Study of the Public Health Resources and the Achievement of Public Health Services in Chuxiong Prefecture Yunnan Province

Author: JiangLiLi
Tutor: LiXiaoMei
School: Kunming Medical College
Course: Epidemiology and Biostatistics,
Keywords: public health resource allocation service effect
CLC: R197.1
Type: Master's thesis
Year: 2011
Downloads: 52
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Abstract

Objective:To analyse the public health resources allocation status, public health service achievement, the residents’needs and utilizations on public health service.Method:Public health service information during 2000 and 2008 was collected from public health facilities and health department. Stratified cluster sampling method was used to collect residents who were interviewed about their needs and utilizations on public health service.Results:1. By the end of 2008, there were total 569 health personnel in the 11 Centers of Disease Control and Prevention(CDC),in which 469 personnel were public health technical staffs.The number of disease control and prevention health technical staffs per 10,000 persons on average was 1.80,with average age of 38.6±6.81yars. The percentage of staff graduated from university and college in prefecture CDC and county CDC were 38.3%,12.5% respectively.The ration of senior, intermediate and junior professional titles was 1.6:4.7:3.8 in prefecture CDC and 0.4:3.2:6.4 in county CDCs. There were 17.1% staffs without any professional title in prefecture CDCs.2. From 2000 to 2008, in Chuxiong prefecture Maternal and Child Health(MCH) technical staffs per 10,000 population increased 3.52% on average.At the end of 2008, the number of MCH technical staffs per 10,000 population was 1.57. The prefecture MCH had 105 staffs, including 51 practitioners(48.6%),38nurses(36.2%); The county MCHs had 31 staffs on average. In all MCHs the practitioners accounted 55.9%, nurses accounted 29.0%. Staff with university and above, tertiary, secondary, high school, junior education level were 16.8%、50.5、28.3%、3.9%、0.5% respectively, and no master degree and above.The ration of senior, intermediate and junior professional titles was 0.6:3.8:5.6.3. By the end of 2008, the number of full-time health educators and psychiatrist per 100,000 population in Chuxiong prefecture was 0.19,1.76; And the number of health supervisor and mental health specialist providers per 10,000 population was 0.57,0.48.4. In 2008,the Chuxiong prefecture government spent 40.23 million on public health which was 0.56% of the government financial expenditure,6.74% of total health expenditure, and the public health expenditure per capita was 15.45. From 2000 to 2008 the Gross domestic product(GDP) and the government financial expenditure of Chuxiong prefecture increased 14.23% and 17.51% on average, while the government financial expenditure on public health increased 1.85%.52.93% of the total income of CDC came from government finance,27.92% came from service providing, and 40.91% of the total expenditure was used in staffs.The total income in MCHs mainly depended on service providing which was about 62.45% and 28.77% of the total expenditure was used in staffs.5. In 2008, the incidence of B types of infectious disease was 142.66 per 100,000. 179,232 people were screened for acquired immune deficiency syndrome(AIDS), and 464 people were diagnosed with HIV and 93.83% of people with HIV were reported timely. The emerging HIV/AIDS comprehensive management of the first follow-up was 100%, and completely follow-up was 94.0%. DOTs covered a population of 2,218 and all the tuberculosis patients were covered.90.13% of pregnant women and 82.93% of the children under 6 years were managed systematically. The maternal mortality rate was 36.92 per 100,000. The infant mortality rate was 13.09%o, and the neonatal mortality was 8.94%o.6. Results from household survey shown that the residents’prevalence of chronic non-communicable diseases was 72.0%o, in which hypertension was the main chronic non-communicable disease with prevalence rate of 2.06% and 34.13% of all chronic non-communicable diseases. The top 5 chronic non-communicable diseases were hypertension, rheumatism and rheumatoid, diabetes mellitus, lumbar disc protrusion, chronic gastroenteritis, heart diseases. The prevalence of severe mental illness was 2.2‰。65.5% of the newborn baby received a medical visit,97.7% of the children had a vaccination card. The coverage rate of Bacille Calmette Guerin(BCG), Measles Vaccine, Poliomyelitis Vaccine, DPT Vaccine, Hepatitis B Vaccine, Vaccine of Epidemic Menigitis, Vaccinum Encephalitidis Epidemicaeand and the five vaccine were 97.69%,94.12%,94.46%,97.69%,96.19%,86.97%,82.93%and 88.47% respectively.60.75%of the women aged 15～49 received the Gynecologic examination in the last year. The prenatal check-up rate and accouchement in hospital rate was 97.0% and 93.5%.66.2% of the puerpera received a visit after acconchement.7. There were difference in the achievement of public health service in different counties. The analysis shown that there were relationship between the score of comprehensive evaluation and the per capita public health costs, per capita public health staffs(The Pearson Correlation was 0.871 and 0.800, P<0.05).Conclusion:1. The public health human resources of Chuxiong prefecture was serious shortage, the staffs’comprehensive quality was lower and needed to be improved. Personnel structure, education level and professional title can not adapt to the current public health needs.2. The growth of government financial expenditure and government expenditure on public health were not synchronized. The government expenditure on public health increased in absolute terms, but decreased in the relative number;serious shortage was consisted in the government investiment in public health, and can not ensure staffs resources and operational requirement to carry out the public health service.3. The controlling of Chronic disease was unsubstantial and the mental illness health services lagged. Although the controlling of infectious diseases,maternal and child health work achieved certain effectiveness but still needed further improvement.4. Increasing the investment in public health and improving the standard of public health human resources can improve the achievement of public health services.

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