Sustainability is a critical issue in China's medical and health assistance and cooperation with Africa.As China enters a new phase in this field,achieving sustainability presents both opportunities and challenges.Summarizing past successes and identifying barriers are of great practical significance for future development.This study examines the current state of China's medical and health assistance and cooperation with Uganda and finds that China has actively sought to integrate into local communities by collaborating with Ugandan medical institutions.However,several factors continue to constrain the sustainability of these efforts,including Uganda's fragmented public-private healthcare system heavily reliant on external aid,the personnel structure of Chinese medical teams,and linguistic and cultural barriers between China and Uganda.Based on official policy documents from both countries and field research findings,this study recommends supporting and assisting Uganda in establishing an independent healthcare system,with a particular focus on maternal and child health,youth health,and chronic disease management.Furthermore,strengthening cultural exchanges can contribute to the sustainable development of China-Uganda and broader China-Africa medical and health assistance and cooperation.

Objective:To explore the relationship between international collaboration papers and academic impact in global health,using the member universities of the Chinese Consortium of Universities for Global Health(CCUGH)as a case study.Methods:The study focuses on journal articles in global health field published by 31 CCUGH member universities between 2014 and 2024.Descriptive statistical analysis of international and non-international collaboration publication volumes was conducted using Excel.Regression analysis and chi-square tests were performed using R to examine the relationship between international collaboration papers and academic impact,and the correlation between the breadth of collaboration and the academic impact of the papers.Results:From 2014 to 2023,the total number of publications,the number of non-international collaborationpublications,and the number of internationally collaborated publications all showed a consistent annual increase,with average annual growth rates of 56.7%,68.3%,and 41.4%,respectively.By the first half of 2024,the total number of publications had increased to 1.5 times that of the corresponding period in 2023.International collaboration positively influenced academic impact,with broader collaborative networks correlating with higher academic influence.Conclusion:The global health publication output of CCUGH member universities has steadily increased,but the volume of international collaboration papers and their proportion remain relatively low.Therefore,it is necessary for CCUGH member universities to strengthen international collaboration papers in global health.

Objective:To analyze the problems and constraints in the development of district hospitals in new cities of Shanghai,and to provide suggestions for the development of district hospitals based on rainbow model.Methods:Using the purposive sampling method,26 key informants from 16 units of health administrative departments,municipal hospitals,and regional medical centers in 5 new cities were selected for on-site research and in-depth interviews,and the research data were analyzed using the thematic framework method.Results:Macro-level planning layout and resource allocation,meso-level organizational linkage and cooperation and competition,and micro-level medical service and talent discipline are important factors affecting the development of district hospitals;there is a mismatch between the realistic development path and functional positioning,mismatch between the institutional mechanism and the demand for effective integration of medical resources,insufficient specialty development and introduction of new technologies,lack of and serious loss of medical talents,limited policy support,inconsistent standards and transfer of resources,and limited policy support.Limited efforts,non-uniform standards poor referral,and other development bottlenecks.Conclusions:It is suggested to strengthen system integration,optimize the planning and layout of health resources in the new city,and guide the differentiated development of hospitals at the city and district levels;Strengthen organizational integration,improve the cooperation and benefit distribution mechanism,and accelerate the construction of close-knit medical consortiums;Optimize the integration of services,accelerate the application of new technologies,and strengthen the construction of specialty alliances;Deepen the integration of functions and norms,coordinate human,financial,and material resources,and solidify the basic support.

Objective:To investigate the synergistic effect and deficiencies between the access path to national medical insurance catalogue and centralized volume-based procurement(VBP)policy,and to provide scientific references to further improve its synergistic effect.Method:The literature analysis method and policy evaluation method were adopted to explore the characteristics of the direct access,negotiated access and bidding access of medical insurance catalogue,and expound the synergistic effect and problems between different inclusion paths and the centralized VBP.Results and Conclusions:The direct access of medical insurance and the VBP policy have formed a policy loop,and have promoted the clinical application of the procured drugs.Under the negotiated access,the VBP of patented drugs is confronted with several practical problems such as the lack of evidence,incompatibility of implementation targets,conflicts in pricing mechanisms and calculation of procurement quantities.The VBP of generic drugs should be vigilant against the inhibitory effect of policy stacking on the innovation impetus.Under the bidding access,the VBP of bidding drugs should not only pay attention to the synergy effect of policies,but also focus on whether the bidding drugs meet the preconditions for centralized procurement,and the impact of the excessive price cuts on the stability of drug supply for pharmaceutical enterprises.

Objective:To understand the workflow and key tasks of the transformation of scientific and technological achievements in public hospitals,and propose optimization strategies from the perspective of managers.Methods:Based on the research method of Grounded Theory,semi-structured interviews were conducted among 23 managers of scientific and technological achievements transformation in public hospitals,and relevant concepts and categories were summarized by three stages coding with NVivo 12.Results:Through the three stages of coding,64 initial concepts,19 categories and 4 main categories were sorted out,and a framework diagram of the process of transforming scientific and technological achievements in public hospitals covering four stages was constructed.Conclusion:The scientific and technological achievements of public hospitals can be divided into four phases:project initiation and demand docking,research and development process and achievements incubation,achievements transformation and market docking,product promotion and industrial development,which can be used to achieve high-quality development of scientific and technological achievements through standardized management of the whole process,excavation of high-quality results,enhancement of humanistic construction,accumulation of scientific research experience,and standardization of qualification of technological managers.

Based on complex system governance theory,this article analyzes the major issues of coordination and integration of medical care system and social medical insurance system,indicating that the mechanisms of control,communication,coordination and integration are not well established.Four policy recommendations are suggested:deepening integration of medical care and insurance systems to better achieve"health-centered"strategy,promoting coordination in reform of provider payment systems to leverage their role in construction of high-quality and efficient medical care,improving efficiency of communication to build a more integrated health information platform,and improving the power balance between medical care system and medical insurance system to adopt advanced financing and service governance system.

Objective:To identify key influencing factors and their structural relationships for continuity of care and care coordination in integrated healthcare systems,providing evidence for systemic improvement strategies.Methods:Taking the Yuhuan Health Consortium in Zhejiang Province as an example,this study integrated the Decision-Making Trial and Evaluation Laboratory(DEMATEL)and Adversarial Interpretive Structure Modeling(AISM).An expert questionnaire and literature review were used to construct a factor system,quantifying the influence degree,centrality,and hierarchical structure of 17 continuity and 14 coordination factors.Results:In the system of continuity of care,division-of-labor and linkage mechanisms(influence degree:2.516)and payment methods(causal degree:1.043)were identified as core drivers,forming a four-level interaction network.For care coordination,health planning(centrality:4.452)and health insurance policies(causal degree:1.131)emerged as root causes,establishing a three-tier hierarchical structure.Topological analysis revealed that continuity relies on the"institutional design-process articulation-patient perception"pathway,while coordination depends on the"policy traction-management synergy-technical support"linkage mechanism.Both systems shared disease characteristics(causal degree:1.650/1.384)as underlying drivers,yet service processes(centrality:4.680)and managerial awareness(centrality:4.754)served as unique hub nodes.Conclusion:Differentiated interventions are required:continuity improvement should prioritize payment reform and division-of-labor mechanisms,while coordination enhancement necessitates strengthened health planning and policy synergy.

The"capitation payment with retained surplus and shared accountability for reasonable overruns"mechanism constitutes a pivotal institutional framework for advancing the high-quality development of County Medical Communities(CMCs).This study addresses two critical operational challenges:identifying the sources of medical insurance fund surplus and optimizing the governance of fund retention processes.Grounded in transaction cost theory,we develop an analytical framework examining the formation of medical insurance fund surplus through the dual lenses of intra-organizational dynamics within CMCs and external medical insurance payment mechanism design.Utilizing Deqing County,Zhejiang Province as an empirical case,this research proposes a five-pronged strategy:Clarifying generation channels of insurance fund surplus,scientifically determining regional medical insurance budgets,implementing bundled payment mechanisms for CMCs,adopting hybrid payment models integrating unified and differentiated approaches,and establishing performance-based incentive systems.These findings elucidate the formative pathways of medical insurance fund surplus while offering theoretical and practical insights for enhancing payment system reforms to support CMC development.

Objective:To study the transmission pathways among empirical policy guidance,innovation diffusion,and health demands,providing theoretical references and policy recommendations for local governments to accelerate the establishment of hierarchical medical system.Methods:Based on the public value theory,and employed policy intensity quantification model and mediation effect validation model to elucidate the specific impact mechanisms of policy guidance and innovation diffusion on health demand.Results:The regression coefficient of local government policy guidance on residents'emergency care demand was 0.677,the regression coefficient of local government policy guidance on treatment model innovation diffusion in hospitals was 0.374,and the regression coefficient of treatment model innovation diffusion in hospitals on residents'emergency care demand was 0.689.The mediating effect of treatment model innovation diffusion in hospitals accounted for 38.1%of the total effect.The mediating effect of treatment model innovation diffusion in municipal administrative divisions accounted for 68.6%of the total effect.Conclusions and Suggestions:Local government policy guidance had a significant positive impact on residents'emergency care demand,innovation diffusion played a mediating role between policy guidance and health demand.It is recommended that local governments should pay attention to the guiding role of public policies and improve the intensity of chest pain center policies,should play the role of innovation diffusion intermediaries and to promote treatment model innovation diffusion in hospitals and administrative divisions two paths.

Objective:This study aims to construct a monitoring index system for early child development(ECD)that is consistent with China's actual situation,to scientifically and systematically evaluate the level of ECD and service capacity in various regions.Methods:The study was predicated on the theoretical foundation of the Nutrition Care Framework(NCF).Indicators were initially selected through a literature review and focus group interviews.The evaluation indicators were then determined through two rounds of expert consultation utilising the Delphi method.The Priority Sequence Diagram Method(PSDM)was subsequently implemented to determine indicator weights.Results:The final framework encompasses six first-level indicators(good health,adequate nutrition,responsive caregiving,opportunities for learning,security and safety,and demand and investment),12 second-level indicators,and 31 third-level indicators.Conclusion:The ECD index system constructed in this study integrates macro,meso,and micro levels,emphasises cross-sectoral collaboration and attention to child caregivers,and incorporates equity indicators to measure regional disparities.The research outcomes provide a reference for quantitatively assessing the level of ECD and service capacity across various regions in China.By leveraging mechanisms for cross-sectoral collaboration and goal-oriented approaches,the study provides a framework for the allocation of resources to key areas,thus laying the foundation for the sustained implementation and resource assurance of the child-priority development strategy.