Factors influencing the provision of public health services by village doctors in Hubei and Jiangxi provinces, China
Factors influencing the provision of public health services by village doctors in Hubei and Jiangxi provinces, China
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DOI：
10.2471/blt.12.109447
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发表时间：
2013-01-01
影响因子：
11.1
通讯作者：
Dong, Hengjin
中科院分区：
文献类型：
--
作者：
Ding, Yan;Smith, Helen J;Dong, Hengjin
问题中国中央政府于2009年启动了卫生系统改革计划，以加强疾病控制和卫生促进，并提供一套基本的公共卫生服务。乡村医生因提供与包裹相关的公共卫生服务而获得了适度的补贴。 Their beliefs about this subsidy and providing public health services could influence the quality and effectiveness of preventive health services and disease surveillance.Approach To understand village doctors' perspectives on the subsidy and their experiences of delivering public health services, we performed 10 focus group discussions with village doctors, 12 in-depth interviews with directors of township health centres and 4 in-depth interviews with directors of county-level Centers for Disease Control and Prevention.Local setting这项研究是在中国中部的四个县进行的，两个在湖北省，两个在江西省进行。自从推出包裹和最低补贴以来，乡镇卫生中心的董事和乡村医生提供提供公共卫生服务的意愿已得到改善，但是乡村医生并没有发现补贴足以为他们的努力提供足够的薪酬。毫无疑问，乡村医生改善了乡村医生提供的公共卫生服务，这可能需要增加乡村诊所和乡村临界人员的支持，以改善乡村诊所和小镇之间的养护。
Problem The Chinese central government launched the Health System Reform Plan in 2009 to strengthen disease control and health promotion and provide a package of basic public health services. Village doctors receive a modest subsidy for providing public health services associated with the package. Their beliefs about this subsidy and providing public health services could influence the quality and effectiveness of preventive health services and disease surveillance.Approach To understand village doctors' perspectives on the subsidy and their experiences of delivering public health services, we performed 10 focus group discussions with village doctors, 12 in-depth interviews with directors of township health centres and 4 in-depth interviews with directors of county-level Centers for Disease Control and Prevention.Local setting The study was conducted in four counties in central China, two in Hubei Province and two in Jiangxi province.Relevant changes Village doctors prioritize medical services but they do their best to manage their time to include public health services. The willingness of township health centre directors and village doctors to provide public health services has improved since the introduction of the package and a minimum subsidy, but village doctors do not find the subsidy to be sufficient remuneration for their efforts.Lessons learnt Improving the delivery of public health services by village doctors is likely to require an increase in the subsidy, improvement in the supervisory relationship between village clinics and township health centres and the creation of a government pension for village doctors.