the current situation and change of china’s public health xiangguang gong chinese center for...
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The Current Situation and Change of China’s Public Health
Xiangguang Gong
Chinese Center for Disease Control and Prevention
March, 2004. Hong Kong
The trends of the number of the institutions for disease control and prevention
147
3580
0
1000
2000
3000
4000
1950 1952 1957 1965 1975 1980 1985 1990 2000 2001 2002
institution for special diseasecontrol and preventioncenter for disease control andprevention
Public Health System in Urban Areas
Ministry of healthChinese center for disease
control and prevention
Province health BureauProvincial center for disease
Control and prevention
Municipal and regionalhealth agency
Municipal and regionalCDC
Center for Community health services
Three level network of health service system in rural areas in China
County CDCCounty hospitalCounty Traditional medicine hospitals
Township hospitals
Village Doctors
0
10
20
30
40
50
60
70
80
1950 1955 1960 1965 1970 1975 1980 1985 1990 1995 2000 2001 2002
0
5
10
15
20
25
30
Trends of the mortality and life expectancy at birth in China
Life expectancy at birth
Mortality
Life expectancy at birth（ years） Mortality（ 1/100,000）
Trends of infant mortality(1949-2002)
28.38
265
0
50
100
150
200
250
300
1949 1950 1955 1960 1965 1970 1975 1980 1985 1990 1995 2000 2001 2002
‰
The main experience of China’s public health
Persist with the health policy of Giving Priority to
Prevention
Broadly developing the EPI around China after the early
1980s
Waging vigorous Sanitation Movement for over 50 years
Establishment of public health system around the country,
especially for the three grade network of health service
system in rural areas.
The Principle Health Policy in different periodsThe Principle Health Policy in different periods
面向工农兵预防为主团结中西医卫生工作
与群众运动相结合
预防为主依靠科技进步动员全社会参与中西医并重
为人民健康服务
农村为重点预防为主中西医并重
依靠科技与教育动员全社会参与为人民健康服务为社会主义现代化
建设服务
50’S 80’S 90’S
面向工农兵预防为主团结中西医卫生工作
与群众运动相结合
预防为主依靠科技进步动员全社会参与中西医并重
为人民健康服务
农村为重点预防为主中西医并重
依靠科技与教育动员全社会参与为人民健康服务为社会主义现代化
建设服务
50’S 80’S 90’S
污水处理
环境清理
灭鼠
Waging vigorous Sanitation Movement for over 50 years
The problems faced with China’s public health
Insufficiently cognizant of the danger of disease
Relatively reduction of the input in public health
The incomplete system of disease control and prevention
Insufficiently cognizant of the danger of disease
Directly determine human’s health Just as the Education, health is the base of
human resource capital The need of concerted development between
society and economy Society stabilization and country security
15.3
30.5
25.5
46.2
59.2
23.3
0
10
20
30
40
50
60
70
80
90
100
1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999
Public Expenditure Social Expenditure Private Expenditure
The structure of total health expenditure in China(1980-1999)
%
The trends of the percent of expenditure of disease control and prevention (EDCP) to government health expenditure, the percent of EDCP to government financial expenditure
13
14
15
16
17
1980 1985 1990 1994 1998 2000 2001
%
0
1
2
3
4 ‰
The percent of EDCP to government health expenditure(%)
The percent of EDCP to government financial expenditure(‰)
The incomplete system of disease control and prevention
Surveillance and information system
Emergency response system
The management system fragmented
The institutions’ equipment is inadequate and out of date
Improper mechanism of revenue of institutions for disease control and
prevention
Team’s capacity a should be improved in the further
Improper mechanism of revenue of institutions for disease control and prevention
Percent of government input to institutions
expenditure(%)
Percent of personnel outlay to institutions
expenditure(%)
Urban 1992
1997
41.8
40.2
30.3
31.9
Rural 1992
1997
47.8
36.2
39.1
38.1
The structure of education level in provincial, regional and county CDC
0% 20% 40% 60% 80% 100%
Provincial CDC
Regional CDC
County CDC
Master or Upper Bachelor Junior College
Technical Secondary School Senior high school Junior high school or lower
The challenge faced with Chinese public health
The aging population The double burden of disease, infection disea
se and non communicable disease Living Style and dietetic habit Urbanization and modernization
Occupational risk Migration population Environment pollution
For 3 years building the public health emergency response system enhancing the system of disease control and prevention enhancing the system of health supervising and executing
the public health law For a longer time
Primary health care system in rural areas The basic health service system in urban areas The environment sanity system Government input system
The goals of Chinese public health building
Establishing the the public health emergency response system
Reinforcing the system of disease control and prevention
Developing health system in rural areas
Enhancing the system of health supervising and executing the public
health law
Expanding health education
Key points in the building process of public health
Increasing the input in public health from government
Reinforcing the duty of government to public health
The participate of other department and community
in public health
Intergrading the gap between clinical medicine and
prevention
The related policy to reinforce the building of public health
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