Assessment on the capacity for programs regarding chronic non-communicable diseases prevention and control,in China / 中华流行病学杂志

ABSTRACT

Objective To 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. Methods On-line questionnaire survey was adopted by 3 352 CDCs at provincial,city and county levels and 1 200 grass roots health care institutions. Results 1)On policies75.0% of the provincial governments provided special fundings for chronic disease prevention and control,whereas 19.7%city government and 11.3% county government did so. 2) Infrastructureonly 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 fundings used for NCDs prevention and control. 3)Capacity on training and guidanceamong all the CDCs,96.9%at provincial level,50.3%at city level and 42.1%at county level had organized trainings 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 participation20.2%of the CDCs had experience in collaborating with mass media. 5)Surveillance capacity64.6% 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 capacity36.1% 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 Assessment13.3% of the CDCs or health administrations carried out evaluation programs related to the responses on NCDs in their respective jurisdiction. 8)On scientific researchthe capacity on scientific research among provincial CDCs was apparently higher than that at the city or county level CDCs. Conclusion Policies 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.