Article type
Year
Abstract
Background: The crisis of server acute respiratory syndrome (SARS) was a smokeless war of human race at the beginning of the new century. More than 30 countries and areas have been involved in this disaster. As a result, 8,439 people have been infected, among whom 812 died. The epidemic put forward a rigid inspection on many countries public health system, especially the one of China. Since the disease mostly occurred in big cities, a municipal public health system is important for the prevention and control of such diseases. Chengdu, a central city in the southwest of China with a 10 million population, representing the situation of developing areas in developing countries, has been chosen to study the construction of municipal public health system.
Objective: To provide evidence and suggestion for the construction of municipal public health system based on the analysis of existing problems.
Methods: Principle and method of evidence-based medicine, epidemiology and health management were applied. The current situation and problems of Chengdu s public health system were described and analyzed on the basis of data search, extraction and evaluation from official website and related files. Countermeasures were then put forward according to research evidence searched from PubMed and CBM.
Results: There are few literatures on municipal public health system, especially the one of developing countries. Almost all related literatures mentioned the importance of health surveillance system in the construction of municipal public health system. Health information system and financing system are also emphasized. The main problem in developing countries is the conflict between heavy health burden and limited resources. The allocation of health resources, including organization and staff, is not competent for the work in both quantity and quality. Inequality of health service exists between the center and outskirt of the city. Among all health organizations, 40.8% are allocated in the city center with a population of 2.5 million, while the remaining allocated in the outskirts with a population of 7.6 million. The insufficient financial support, hardware and software condition deteriorated the serious situation of public health. The health financing from government decreased from 2% of GDP in 1990 to 1.34% in 2001. In 2002, the financial appropriation per capita was 0.51 RMB in Chengdu, while 5.35 RMB in Beijing, 2.81 RMB in Guangzhou and 2.81 RMB in Hangzhou, respectively. There are 11% of health staff lacking enough education and training, and 20% of them without health related background.
Conclusion: The poor capacity of the municipal public health system in Chengdu has harmed its function seriously. It is suggested that we should adopt the strategies as follows: establishing a managing committee of the public health system; making comprehensive plan to set up 6 professional centers; sponsoring research on main diseases and key techniques; increasing financial appropriations by improving financing mechanism; establishing a center for education and staff training.
Objective: To provide evidence and suggestion for the construction of municipal public health system based on the analysis of existing problems.
Methods: Principle and method of evidence-based medicine, epidemiology and health management were applied. The current situation and problems of Chengdu s public health system were described and analyzed on the basis of data search, extraction and evaluation from official website and related files. Countermeasures were then put forward according to research evidence searched from PubMed and CBM.
Results: There are few literatures on municipal public health system, especially the one of developing countries. Almost all related literatures mentioned the importance of health surveillance system in the construction of municipal public health system. Health information system and financing system are also emphasized. The main problem in developing countries is the conflict between heavy health burden and limited resources. The allocation of health resources, including organization and staff, is not competent for the work in both quantity and quality. Inequality of health service exists between the center and outskirt of the city. Among all health organizations, 40.8% are allocated in the city center with a population of 2.5 million, while the remaining allocated in the outskirts with a population of 7.6 million. The insufficient financial support, hardware and software condition deteriorated the serious situation of public health. The health financing from government decreased from 2% of GDP in 1990 to 1.34% in 2001. In 2002, the financial appropriation per capita was 0.51 RMB in Chengdu, while 5.35 RMB in Beijing, 2.81 RMB in Guangzhou and 2.81 RMB in Hangzhou, respectively. There are 11% of health staff lacking enough education and training, and 20% of them without health related background.
Conclusion: The poor capacity of the municipal public health system in Chengdu has harmed its function seriously. It is suggested that we should adopt the strategies as follows: establishing a managing committee of the public health system; making comprehensive plan to set up 6 professional centers; sponsoring research on main diseases and key techniques; increasing financial appropriations by improving financing mechanism; establishing a center for education and staff training.