Abstract
BackgroundEqualizing basic public health services (BPHS) for all has been one goal of the health system reform in China since 2009. At the end of the 12th five-year plan, we conducted a series of surveys to understand BPHS implementation in Southwest China, and firstly reported implementation of health education (HE) and explore the barriers to HE delivery.MethodsMixed research methods were used to investigate achievement in and barriers to HE in Southwest China. SPSS 22.0 was used for data analysis.ResultsNine hundred and eighty-nine residents were surveyed by questionnaire. 16 health care workers (HCWs) and 16 directors from 16 PHC sectors were included in the in-depth interviews. Less than 50% of residents who knew or utilized some item of HE. Age, residence, region (Chongqing or Guizhou), marital status, education, occupation, type and quality of primary health care (PHC) sectors to deliver BPHS, self-reported health and status of chronic diseases were associated with knowledge or utilization of HE. Distance to PHC sectors was associated with the knowledge of HE, gender and health insurance were associated with utilization of HE. Age, marital status, occupation region and self-reported health were associated with satisfaction regarding HE. Barriers to HE delivery included defects in HE design, weak capacity in PHC sectors to provide HE, residents’ poor cooperation, lack of multi-sector cooperation, poor equipment and weak health system.ConclusionsSouthwest China delivered HE in all PHC sectors. However, our study underlined many barriers to equalization of HE. To address those barriers and achieve HE quality improvement, comprehensive measures to improve capacity of PHC sectors, enhance multi-sector cooperation and strengthen health information systems are all urgent needs.
Highlights
Equalizing basic public health services (BPHS) for all has been one goal of the health system reform in China since 2009
primary health care (PHC) sectors in each selected county/district were divided into township health centers (THCs) in rural and community health centers (CHCs) in urban areas
Our study found that fewer residents knew about health education (HE) materials, and only about 50% of residents knew about health lecture and health materials provisions in PHC sectors
Summary
Equalizing basic public health services (BPHS) for all has been one goal of the health system reform in China since 2009. One of the important strategies to promote health equity in this new health care reform is to promote universal access to public health services and for government to set the goal of equalizing access to basic public health services (BPHS) [9]. In 2009, the core basic package of BPHS included nine categories (residents’ health records, health education, immunizations, health management for children, infectious disease prevention and control, maternal health management, health management for the aged, chronic disease management and management of patients with severe mental illness) and 21 items with 15CNY(Chinese Yuan) subsidies perperson were proposed [9, 10]. In 2016, BPHS had 12 categories and 48 items (included two TB (Tuberculosis) management items compared with 2015) with 45 CNY subsidies per-person [15]
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