Based on a survey of community health service organization in several cities, community health service model based on the family clinic was compared with state-owned community health service model, and status quo, advantages and problems of family community health service organization were analyzed. Furthermore, policies for the management of community health service organization based on the family clinic were put forward.
China ; Community Health Services/*methods ; Community Health Services/*organization & administration ; Data Collection ; Delivery of Health Care/organization & administration ; Hospitals, Community/*organization & administration

Based on a survey of community health service organization in several cities, community health service model based on the family clinic was compared with state-owned community health service model, and status quo, advantages and problems of family community health service organization were analyzed. Furthermore, policies for the management of community health service organization based on the family clinic were put forward.
China ; Community Health Services ; methods ; organization & administration ; Data Collection ; Delivery of Health Care ; organization & administration ; Hospitals, Community ; organization & administration ; Humans

In Papua New Guinea there are many organizations providing sparsely spread and fragmented health services. Government health facilities are often relatively well functioning in urban and periurban areas, but sporadic or nonexistent in rural areas. In some remote areas churches are the major health service providers. Increasingly other community groups are providing village-based health services. Much financial support is now pledged by major international donors for community-based health services, but few people working at a district or community level have the management skills to access the funds or plan programs effectively, and few of the major donors have any significant presence in rural areas. Such a management skill gap also exists at the level of many provincial health offices and this seriously limits the effectiveness of all major donor projects. There is need for integration of health services to avoid replication and to extend services to areas where no effective services are currently provided. There is also a great need to train people at a community and district level in program planning and management. Non-government organizations (NGOs) working at a district or community level have the potential to bridge this skill gap and to help integrate community-based services with government institutions. This paper reports, as an example, the activities of Save the Children, an international NGO in Papua New Guinea. Essential for the success of community-based health projects is the development of local management skills, reliable funding, integration with established health institutions, objective evaluation and community support. Skilled NGOs working at a community, district or provincial level can have important roles in assisting local people to run effective and sustainable health programs.
Child ; Child Health Services - organization & ; administration ; Child Welfare ; Community Health Planning ; Community Health Workers ; Papua New Guinea

PURPOSE: This study was a part of a drive to develop a community health center-based hospice management model which is concerned with hospice care at a community health care setting and available resources of the local community. METHODS: Development of a community health center-based hospice management model involved evaluation of existing hospice-related research, including literature review, and research on hospice facilities at the study site, as well as evaluation of model operation. The latter involved community health center-based hospice test operation, and evaluation of test operation by a research team, including of a nursing professor majoring in hospice care and staffs from a community health center in Busan metropolitan city, regional cancer center, and regional terminal cancer patient medical institute. The study was conducted in the 2008 calendar year. RESULTS: The community health center-based hospice management model provides service linked with local community resources, focusing on the local community health center. Financial and administrative assistance is provided by the regional cancer center, with collaboration from academic health care professionals who guide the operation management. The community health center hospice nurse in consultation with a visiting nurse team registers terminally-ill cancer patients and, after assessment, the hospice team prioritize hospice care during team meeting. Care is delivered by staffs and volunteers. CONCLUSION: The developed community health center-based hospice operation management model maximally utilizes available community health resources to produce qualitative improvement of regional health and welfare policy through improving the lives of home-based cancer patients and their family who are in medical blind spot.
Community Health Centers ; Community Health Nursing ; Community Health Services ; Cooperative Behavior ; Delivery of Health Care ; Health Resources ; Hospice Care ; Hospices ; Humans ; Models, Organizational ; Optic Disk ; Organization and Administration ; Pilot Projects

No abstract available.
Community Mental Health Services/organization & administration ; History, 20th Century ; Hospitals, Psychiatric/organization & administration ; Humans ; Japan ; Mental Disorders/rehabilitation ; Mental Health Services/history/*organization & administration/statistics & numerical data

Background: HIV/AIDS pandemic really become danger to mankind on the earth. Objectives: Description epidemiological characteristics of HIV/AIDS patients. Studying clinical expression, learning aboutdemands of infected patients and community care for infected patients. Subjects and method: 71 HIV/AIDS people in Thua Thien Hue were studied in 2006. Using descriptive method to give epidemiological characteristics and behaviour of HIV/AIDS people. People were determined HIV/AIDS infection based on the criteria of Ministry of Health. The information were collected by target study. Results: HIV/AIDS people mainly from the age of 20 to 39 (83,10%), males were 52,10% and in various levels of education and all kinds of occupation. The rate of sexually transmitted infection was 84,5% and infection transmission was 15,5%. The rate of sexually transmitted infection within the last 12 months was 57,7%. 63,4% of infected people used condom while having sex with their spouses or partners. 1,4% of infected people using drug infection within the last month. 38% of the infected people had manifestations of AIDS, 77,8% of HIV/AIDS were treated with antiviral drugs. Families and communities had positive attitudes and behaviors to the HIV/AIDS people. Infected people being remoted from the society was 12,7%, 88,7% of them receiving supports from their communities such as disease treatment, spirit and material supports and job opportunities. Conclusion: Strengthen communication activities to change behavior of HIV/AIDS people and in communitiy to reduce alienation, discrimination for infected people. Execute socialization in care and support for HIV/AIDS people.
HIV/ immunology ; isolation & ; purification ; pathogenicity ; Community Health Services/ organization & ; administration ; Epidemiologic Methods ;

OBJECTIVETo assess the policies and programs on the capacity of prevention and control regarding non-communicable diseases (NCDs) at the Centers for Disease Control and Prevention (CDCs) at all levels and grass roots health care institutions, in China.

METHODSOn-line questionnaire survey was adopted by 3 352 CDCs at provincial, city and county levels and 1 200 grass roots health care institutions.

RESULTS1) On policies: 75.0% of the provincial governments provided special funding for chronic disease prevention and control, whereas 19.7% city government and 11.3% county government did so. 2) Infrastructure:only 7.1% county level CDCs reported having a department taking care of NCD prevention and control. 8 263 staff members worked on NCDs prevention and control, accounting for 4.2% of all the CDCs' personnel. 40.2% CDCs had special funding used for NCDs prevention and control. 3)Capacity on training and guidance:among all the CDCs, 96.9% at provincial level, 50.3% at city level and 42.1% at county level had organized training on NCDs prevention and control. Only 48.3% of the CDCs at county level provided technical guidance for grass-roots health care institutions. 4) Capacities regarding cooperation and participation: 20.2% of the CDCs had experience in collaborating with mass media. 5) Surveillance capacity: 64.6% of the CDCs at county level implemented death registration, compare to less than 30.0% of CDCs at county level implemented surveillance programs on major NCDs and related risk factors. In the grass roots health care institutions, 18.6% implemented new stroke case reporting system but only 3.0% implemented program on myocardial infarction case reporting. 6) Intervention and management capacity: 36.1% and 32.2% of the CDCs conducted individualized intervention on hypertension and diabetes, while less than another 20% intervened into other NCDs and risk factors. More than 50% of the grass roots health care institutions carried follow-up survey on hypertension and diabetes. Rates on hypertension and diabetes patient management were 12.0% and 7.9% , with rates on standard management as 73.8% and 80.1% and on control as 48.7% and 50.0%, respectively. 7) Capacity on Assessment: 13.3% of the CDCs or health administrations carried out evaluation programs related to the responses on NCDs in their respective jurisdiction. 8) On scientific research: the capacity on scientific research among provincial CDCs was apparently higher than that at the city or county level CDCs.

CONCLUSIONPolicies for NCDs prevention and control need to be improved. We noticed that there had been a huge gap between county level and provincial/city level CDCs on capacities related to NCDs prevention and control. At the grass-roots health care institutions, both prevention and control programs on chronic diseases did not seem to be effective.

Aged, 80 and over ; Community Health Services ; Female ; Humans ; Male ; Pilot Projects ; Terminal Care ; organization & administration

OBJECTIVE: To develop a capacity questionnaire in public health emergency for Chinese local governments. METHODS: Literature reviews, conceptual modelling, stake-holder analysis, focus group, interview, and Delphi technique were employed together to develop the questionnaire. Classical test theory and case study were used to assess the reliability and validity. RESULTS: (1) A 2-dimension conceptual model was built. A preparedness and response capacity questionnaire in public health emergency with 10 dimensions and 204 items, was developed. (2) Reliability and validity results. Internal consistency: except for dimension 3 and 8, the Cronbach's alpha coefficient of other dimensions was higher than 0.60. The alpha coefficients of dimension 3 and dimension 8 were 0.59 and 0.39 respectively; Content validity: the questionnaire was recognized by the investigatees; Construct validity: the Spearman correlation coefficients among the 10 dimensions fluctuated around 0.50, ranging from 0.26 to 0.75 (P<0.05); Discrimination validity: comparisons of 10 dimensions among 4 provinces did not show statistical significance using One-way analysis of variance (P>0.05). Criterion-related validity: case study showed significant difference among the 10 dimensions in Beijing between February 2003 (before SARS event) and November 2005 (after SARS event). CONCLUSION The preparedness and response capacity questionnaire in public health emergency is a reliable and valid tool, which can be used in all provinces and municipalities in China.
China ; Community Health Services ; Disaster Planning ; organization & administration ; Emergency Medical Services ; organization & administration ; Humans ; Public Health ; education ; Risk Assessment ; Surveys and Questionnaires

The community health practitioners (CHP) play an important role in primary health care services to the underserved population in rural area. Time and motion study of 26 CHPs in Kyungpook Province was conducted through work diary method for 6 consecutive days from the time they arrived until they left the primary health post (PHP) during the past 3 weeks from November 16 to December 5, 1987. The allocation of activity time by working category, service category, location of activity and CHP's function was analyzed according to the characteristics of CHPs i. e., age, marital status and experience as CHP. The major findings are as follows: The mean activity time per CHP in a week was 2,918 minutes. The length of their working hours as longer for older, married and more experienced CHPs than other. About 80% of the CHP's activities took place within the PHP and only about 20% occurred outside of the PHP. Working hours for the outdoor activities were longer for younger, single and less experienced CHPs than others. The allocation of activity time by working category showed 46.3% in the technical work and 18.7% in the administrative work. Working hours for the technical activities were longer for younger, single and less experienced CHPs than others. The percentage of activity time revealed greatest as much as 63.1% for direct patient care in technical word and 61.6% for record keeping in administrative work. Of the total working hours in a week, direct patient care and public health activities accounted for 29.2.% and 16.2%, respectively. Of the indoor activities, working hours for direct patient care were longer than those for public health activities. However, of the outdoor activities, working hours for public health activities were longer than those for direct patient care. The allocation of activity time by CHP's function showed 49.7% in management of common disease, 31.8% in management of PHP and technical supervision of village health workers, 9.5% in MCH and family planning, 6.6% in community health management and 2.4% in community approach. Based on these findings, it was found that CHPs were mainly working in the PHP with a majority of their time being spent of direct patient care rather than preventive and promotive health cares. To enhance the preventive and promotive health services of the CHPs and to involve the activities for community development, refresher course for CHPs should be reinforced and supervision mechanism of the CHPs should be established and operated in Gun- and province- level.
Community Health Workers ; Family Planning Services ; Gyeongsangbuk-do ; Health Services ; Humans ; Marital Status ; Methods ; Organization and Administration ; Patient Care ; Primary Health Care ; Public Health ; Social Change ; Vulnerable Populations