A Survey on the Human Resource Allocation of Chengdu Rural/Community Health Service Organizations: A Pre-Survey Report of Three Circles, Seven Rural Hospitals/Centers and Six Village Health Situations (Part II)

Objective To investigate human resource allocation in primary health care and the essential medical service and public health service status in urban and rural areas in Chengdu, so as to provide baseline data for the Special Healthcare Program of Comprehensive Reform for Coordinated and Balanced Urban-Rural Development in Chengdu. Methods We carried out a stratified (three circles in Chengdu) sampling of 7 township hospitals (rural hospitals) and community health service centers; and then performed secondary research based on a comparative analysis of relevant policies of the World Health Organization (WHO) and Chinese governments at all levels. Results According to the WHO and national average standards, the number of staff per 1 000 rural hospitals / centers health personnel of the 7 rural hospitals / centers occupied only 1%-22% of the global average standard. There was a very large gap between the number of staff and the number of personnel required, based on the size of the population that should be served in the administrative areas in 2006 or the number of clinic patients in 2006. The primary healthcare personnel structurewas irrational. For example, the constituent ratio of health technical personnel was 4% to 33% higher than the global average level, and the constituent ratio of (assistant) physicians was also 17% to 45% higher than the global average level. However, the ratio of nurses, laboratory workers, other health professionals, administrative and supporting personnel was generally lower than the global average level. Women dominated among the primary healthcare personnel, and people aged 45 years or below counted for more than 75% (except Bailu and Wangjiang rural hospitals/centers). People with an educational background of two-year college education or secondary education or below took up 70% to 90%; while those with an intermediate title or assistant /primary title accounted for 50% to 100%. The structure rationality of distribution density, educational background and academic titles of healthcare personnel showed a decreasing trend from the first circle to the third circle in Chengdu city. Conclusion The primary health workers in the second and third circle have been overloaded with low incomes for some time. They are facing enormous challenges in their professional skills, service awareness, as well as difficulties in continuing education and professional title promotion. It is very difficult to provide qualified six in one primary health care and public health services in a long-term and stable manner. It is suggested that we enroll and train more skilled people for primary health care service, and provide continuing education chances for current health care personnel. We should also adopt a mechanism to select qualified personnel based on their performance, and take measures to solve some of the problems faced by the grass-root health personnel, such as heavy work burden, low income, poor skill and promotion. This will help us to construct a stable and qualified primary healthcare team.