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Investigation report on rural hygiene and health
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In 2005, under the correct leadership of the municipal party committee and the municipal government, and with the strong support of the superior health department, our town's health work adhered to the guidance of Theory of Three Represents, focusing on the integrated management of township medical institutions, community health services, the reform of health centers, the new rural cooperative medical care and patriotic health work, further deepened the reform, seized the opportunity, improved the mechanism and strengthened measures, comprehensively completed all tasks of rural health work, and promoted the development of rural health undertakings. Report the annual work to the leaders as follows: 1. Highlight key points, promote the healthy development of rural health work in the town, increase investment, and timely and fully allocate health funds. My town attaches great importance to rural health work, always puts this work on the important agenda of the party Committee and government, and constantly increases investment in health undertakings. By the end of 1 1, the town finance had allocated a total of RMB 10,000 yuan for health care, which effectively guaranteed the all-round development of rural health work. 2, strict standards, accelerate the pace of health diagnosis and treatment. According to the "Decision on Further Strengthening Rural Health Work" of the municipal government, combined with the reality of rural health work in this town, our town has formulated the "Plan for Upgrading and Renovating the Equipment of Rural Health Institutions in xx Town in 2005-2005", and established a village-level health center with the mayor as the team leader, the leaders in charge as the deputy team leader, and relevant departments participating, which is responsible for the development of the town's health centers. Since the beginning of this year, a total investment of more than 400,000 yuan has been made to build three new hospitals in Beitao, Gao Xi and Taiping and three hospitals in Duhongli, Li Mao and Beiguan with high standards. In order to improve the staff's understanding of face-lifting work, our town concentrated time on organizing all hospital leaders to visit three newly-built hospitals and held a special mobilization meeting, which stimulated the enthusiasm of other hospitals for face-lifting work. While doing a good job in clinic construction, our town has focused on strengthening the beautification and greening of community service stations. The green area of community service stations in Chen Kang, Yabei, Beitao, Yan Jia, Li Mao and Dafu Village has reached or exceeded 500 square meters. Up to now, 26 of the 37 health centers in our town have reached the standard of "five rooms separated and four modernizations" in Jinan Grade A health center, accounting for 70% of the total number of health centers. Add comments

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Rural health work is the focus of China's health work, which is related to protecting rural productive forces, revitalizing rural economy and maintaining rural social development and stability. In order to promote the development of health in our county, at the beginning of the year, the Standing Committee of the County People's Congress listed rural health work as an important deliberation topic this year. Before deliberation, an investigation team headed by Zhang Jianping, deputy director of the Standing Committee of the County People's Congress, was organized to investigate the rural health work in our county. He has listened to the relevant work reports of the county health bureau, visited Xiage, Fu Ying and other 12 towns and streets, and visited five county-level medical institutions and eight township (center) health centers, respectively, and held symposiums for heads of relevant departments and medical institutions, such as the Food and Drug Administration and so on 13, to listen to opinions and understand the situation. The investigation is hereby notified as follows:

I. Basic information

In recent years, the county government and health departments adhere to the people-oriented principle, conscientiously implement a series of policies and relevant laws and regulations of the party and the state on rural health work, strengthen rural health work, establish and improve the rural medical and health service system, and promote the development of rural public health. Mainly reflected in the following three aspects:

(1) Rural health work has been attached importance by governments at all levels.

In recent years, the county government has taken rural health work as an important part of new rural construction, put it on an important agenda and incorporated it into the county's "Eleventh Five-Year" economic and social development plan. Relevant policy documents such as the Implementation Opinions on Strengthening Rural Public Health Work and the Trial Opinions on Establishing a New Rural Cooperative Medical Security System have been formulated and promulgated successively. Provinces, cities and counties all attach great importance to the investment in rural health. In 2006, * * * invested 44.5 million yuan, including county finance18.95 million yuan, which increased the investment in public health care. Actively carry out publicity and education on health-related policies, laws and regulations and health knowledge. All towns (streets) attach importance to health work, clearly define the leaders in charge, establish working mechanisms, strengthen the implementation of work, and do a good job in rural health work in this area.

(2) Rural public health work has been solidly promoted. First, the implementation of the farmer health project has achieved remarkable results. "Farmers' Health Project" is a practical project jointly implemented by provincial, municipal and county governments in 2006. Our county has comprehensively developed three categories of rural public health services 12. In 2006, more than 30,000 farmers were provided with free health check-ups, health records were established and classified management was implemented. The project has been affirmed by the relevant leaders at higher levels, and many media such as CCTV have successively conducted interviews and reports. The new rural cooperative medical system operates in an orderly manner. In the past three years, the framework of the new rural cooperative medical system has been basically established, and an effective operating mechanism has taken shape. In 2007, there were more than 330,000 insured persons in the county, and the participation rate was 78%. Nearly 400,000 people enjoyed the compensation of the new rural cooperative medical system, which reduced the medical burden of the insured farmers' patients to some extent. The second is to effectively prevent and control rural diseases. Adhere to the policy of putting prevention first, attach great importance to the prevention of infectious diseases such as SARS and human avian influenza, and effectively control key infectious diseases. With the implementation of immunization program, the vaccination rate of children's "five vaccines" reached over 95%. Actively carry out the propaganda of infectious disease prevention knowledge and the prevention and treatment of chronic non-communicable diseases, and there is no major epidemic in the county. Third, actively do a good job in rural maternal and child health care. Solidly carry out the "maternal and child health project" work. In 2006, pregnant women achieved zero death for the first time, and the child mortality rate decreased year by year. Fourth, vigorously carry out environmental sanitation rectification activities. Efforts will be made to improve the sanitary environment, with emphasis on improving water and toilets. At present, tap water stations have been built in 560 natural villages in the county, with a population of more than 6.5438+0.9 million, more than 8,000 open pit toilets have been demolished, 349 new toilets have been built and 47,000 toilets have been renovated. Fifth, outstanding achievements in blood donation. The county's blood donation work has been rated as "advanced blood donation county" at the provincial and municipal levels for six times. From June 5438 to October 2004 10, the county government, as the only county-level unit in China, won the national promotion of blood donation award.

(3) The rural medical and health service system has been gradually improved. First, establish and improve the health service network at the county, township and village levels. There are 7 county-level medical and health institutions, 18 township (center) hospitals as community health service centers and 42 village-level community health service stations. The second is to carry out the reform of share responsibility system in township (center) hospitals and fully implement the economic target management responsibility system in central hospitals. The implementation of farmers' health project and the improvement of service mode have improved the operating conditions of township (center) hospitals. Third, the construction of rural health talents has been strengthened. Strictly control the entrance of personnel, strictly control the requirements, recruit outstanding graduates and enrich rural medical institutions. The quality improvement project of rural health technicians was implemented, and the professional level of rural health technicians was further improved through the selection of "Top Ten Residents", various business trainings and academic education. The fourth is to do a good job in the construction of medical quality. The work plan of medical quality construction in Xianju county was formulated to strengthen the capacity building of medical units and improve the management level and service level of hospitals through grade evaluation. Carry out the activity of "strengthening medical quality management, striving for a hundred days without accidents", earnestly strengthen medical safety education, implement the medical quality responsibility system, and enhance the sense of responsibility and security of medical staff. We have formulated and improved the medical quality assessment standards for township (center) hospitals, established a monthly supervision and notification system, and made good efforts to supervise and implement them. Fifth, health supervision has been continuously strengthened. Conscientiously implement the "Food Hygiene Law" and the "Occupational Disease Prevention Law", and do a good job in special rectification of food safety, hygiene license and occupational health. Strengthen the comprehensive law enforcement of rural health to promote food hygiene and drug safety.

Second, the main problems

(A) the rural health work atmosphere is not strong. Governments at all levels and relevant departments have insufficient understanding of the importance of doing a good job in rural health work, and the awareness of people-oriented social development and health-oriented human development and the concept of great health are not strong enough to form a joint force of rural health work. The publicity and education of health laws, regulations, policies and health knowledge are not enough. The broad masses of people have a weak sense of health subject and lack the concept of health protection and basic health care knowledge. The idea of putting prevention first has not yet formed knowledge, and the concept of emphasizing treatment over prevention has not changed.

(B) The rural medical and health service capacity is not strong enough. First, the infrastructure of medical institutions lags behind. Medical institutions in our county generally lack development planning, and the business premises are very tight. As the largest comprehensive hospital in the county, the county people's hospital covers an area of only 40 mu, and the medical room is very crowded, which can't meet the medical service needs of the masses. In 2003, the hospital relocation project was approved and approved, but due to various reasons, it has not yet started, which seriously restricts the construction and development of the hospital. County hospitals such as Chinese medicine hospitals, maternity hospitals and mental hospitals, and central health centers such as Hengxi, Baita and Xiaxia are short of business premises. The houses in mental hospitals are tight and the conditions are simple. County CDC and Chengguan Hospital are still renting houses to work. Most medical units generally have problems such as backward facilities and equipment, and township hospitals are not equipped with ambulances, so it is difficult to carry out effective medical and health services. Second, the construction of medical technicians is incompatible with the development of medical and health undertakings. There is a shortage of medical and health personnel in the county, especially those with high academic qualifications and titles. Of the 1350 health technicians in the county, only 14.9% has a bachelor's degree and only 6.8% has a senior title. Rural health technical strength is even weaker, with 5 14 health technicians, only 16 undergraduate education, only 6 senior titles and 96 intermediate titles. The talent problem seriously affects the level of medical technology, medical quality and medical credibility. The working environment of grassroots medical staff is poor, the pressure is high, the salary is low, and basic social security such as old-age insurance and medical insurance has not been implemented. Third, the quality of medical care still needs to be improved and the medical order needs to be standardized. The service consciousness of medical staff is not strong enough, and there are many cases of patient outflow; The occurrence of medical disputes is on the rise, and medical incidents occur from time to time, which is difficult to handle; There are many individual medical units, which are difficult to manage and crack down on illegal medical practice. Fourth, the village-level health service network is weak. There are only 42 village-level service stations in 722 administrative villages in the county, which greatly reflects the inconvenience of people seeking medical treatment.

(3) Rural public health construction is slow. First, there are still weak links in disease prevention and control and maternal and child health care. The task of preventing infectious diseases and major diseases is still very heavy, and the people's concept of disease prevention is not strong. Second, food safety hazards and drug regulatory issues have been greatly reflected. The problem of transferring agricultural products has become increasingly prominent, the detection system of agricultural products is not perfect, the detection facilities and equipment are backward, and the quality and safety management of agricultural products such as grain and vegetables is outstanding. The rural drug supply network is not perfect, drug supervision is relatively weak, and it is difficult to guarantee the safety of people's drug use. Third, the task of improving rural environmental sanitation is arduous. The problem of drinking water quality safety in rural areas is more prominent. There are no centralized water supply facilities in Hengxi, Baita and other towns and surrounding plain villages and suburbs. Because of groundwater pollution, the problem of drinking water safety is outstanding, and the voice of the masses is louder. Open pit is still widespread, and the task of toilet improvement is heavy. Although some villages built public toilets, the follow-up management failed to keep up and did not play a role; The progress of domestic waste treatment project in county is slow, the operation mechanism of urban and rural domestic waste treatment is lacking, the sanitary facilities are lacking, and the problem of garbage treatment is outstanding; Pollution problems have not been taken seriously, sewage facilities are not matched, and underground pollution is serious. The existence of the above public health problems has led to the phenomenon of returning to poverty due to illness.

4) Rural health investment is relatively insufficient. Although the county-level financial investment in medical and health care is increasing every year, the proportion of medical and health funds in the financial expenditure at the same level is declining. The channels for social funds to invest in health care are not wide and the number is small. Due to insufficient investment, it restricts the public health construction such as disease prevention and control, health law enforcement supervision, water improvement and toilet improvement, as well as the infrastructure construction and equipment renewal of medical and health units, which affects the development speed of rural health in our county.

(E) The new rural cooperative medical system is not perfect. First, the policy propaganda on agricultural medical insurance is not enough, some farmers have a biased understanding of agricultural medical insurance, and the people's enthusiasm for participating in insurance is not high. Second, the agricultural medical insurance policy is not perfect. The masses have many opinions on outpatient reimbursement, reimbursement procedures for medical treatment in different places, quota and participation rate. Third, financing is difficult. There are so many people going out in our county that it is difficult to collect them by households. Some rural cadres are afraid of difficulties. Villages with collective economy are collectively funded, which affects the development of village economy and has a great response from cadres.

Third, some suggestions.

(A) to further strengthen the concept of health care for development, and create a good atmosphere for the whole society to do a good job in rural health work. Health is the greatest wealth in life. Doing a good job in rural public health, strengthening medical and health services and improving people's health level are major events that benefit the people, major tasks that build a harmonious society and promote coordinated economic and social development, and unshirkable responsibilities of party committees and governments at all levels. County governments should fully understand the great significance of strengthening rural health work from the height of implementing the responsibility of governing for the people and further strengthen the overall leadership of rural health work. Thoroughly implement the central, provincial and municipal policies on rural health work, formulate rural health development plans, define objectives, implement the responsibilities and tasks of relevant departments and towns (streets) in rural health work, strengthen organization and coordination, and form an overall joint force of close cooperation and joint efforts of relevant departments and towns (streets). It is necessary to attach importance to and strengthen the publicity and education of health laws, regulations, policies and health knowledge, raise people's awareness of health subject, enhance the concept of preventive health care, mobilize all social forces to do a good job in rural health work, and create a social atmosphere that guarantees health and promotes development.

(two) to further strengthen the rural medical and health construction, improve the level of medical technical services.

First, we must strengthen the infrastructure construction of medical institutions. It is necessary to coordinate the development of various medical institutions and define the scale of development. We should attach great importance to the construction of county people's hospitals, study as soon as possible, scientifically determine the construction plan, actively organize the implementation, and speed up the solution to the outstanding problems of housing shortage in county people's hospitals. Attach importance to the development of county-level medical institutions and township (center) hospitals, pay close attention to the relocation project of county CDC and Chengguan Hospital, actively help solve the expansion problems of county traditional Chinese medicine hospitals, maternity hospitals and central hospitals such as Hengxi, Baita and Xiaxia, and attach importance to solving practical problems such as housing shortage, backward medical conditions and insufficient funds in county psychiatric hospitals and some township hospitals. Update the facilities and equipment of medical institutions, improve the credibility of physical examination and meet the needs of medical development.

Second, we should strengthen the construction of medical technicians. The survival and development of medical institutions depend on the level of medical technology, and medical technical talents determine the level of medical technology. Therefore, it is necessary to strengthen the introduction and training of medical technical talents, establish and improve the talent introduction mechanism, improve the talent introduction and assessment policies, and rationally allocate talents. Strengthen the education and training of on-the-job medical personnel, continuously increase the proportion of middle and senior doctors and practicing doctors, and further improve the overall quality of medical technicians. Pay attention to solving basic social security problems such as endowment insurance and medical insurance for medical and health personnel.

Third, strengthen the construction of medical quality and standardize medical order. The county people's hospital should cultivate and gather high-quality and sophisticated medical experts, constantly push the county's medical and health technology to a new level and reduce the outflow of patients. Township (center) hospitals should strengthen the construction of medical capacity and continuously improve the level of general medical skills. Strengthen medical quality management and reduce the occurrence of medical accidents. We should attach importance to the advantages and functions of traditional Chinese medicine in rural health services, and actively explore, collect and sort out folk medical technology and ancestral secret recipes. It is necessary to strengthen the construction of medical ethics, do a good job in the construction of medical ethics, and enhance the service awareness and professional self-discipline awareness of medical staff. Strengthen the management of individual medical units, give full play to the positive role of individual medical units in facilitating medical treatment for people in mountainous areas, resolutely crack down on all kinds of illegal medical practices that endanger farmers' health, and standardize medical order.

Fourth, deepen the reform of the medical and health management system. It is necessary to follow the principles of government-led, social participation, changing mechanism and strengthening supervision, start with solving the most prominent problems reflected by the masses, deepen the reform of medical and health management system, improve the operating mechanism of medical institutions, strengthen public service functions and standardize service behavior. It is necessary to promote the reform of township (center) hospitals, rationally allocate resources, improve the service model, form a dynamic employment mechanism and distribution incentive mechanism, and improve efficiency. Strengthen the construction of village-level health community service network, and undertake the tasks of initial diagnosis of common diseases and preventive health care. Give full play to the role of medical institutions organized by individuals in society, improve the integration of rural health service management and improve the overall efficiency.

(3) Further strengthen the construction of rural public health to provide basic protection for farmers' health. Public health is the source of people's health. The first is to strengthen disease prevention and control. It is necessary to adhere to the principle of putting prevention first and combining prevention with treatment, strengthen the prevention and control of major diseases such as key infectious diseases and occupational diseases, improve the construction of emergency system for public health emergencies in rural areas, and improve the ability to deal with major epidemics and public health emergencies. Second, we should strengthen maternal and child health care. Conscientiously implement the maternal and child health project, attach importance to the construction of obstetrics and pediatrics, strengthen maternal and child health care, and improve the basic quality of the birth population. Third, we should strengthen the hygiene and safety management of drugs and food. It is necessary to establish and improve the rural drug supply and supervision network, strengthen the supervision of drug purchase and sale, and organize the inspection of drug procurement channels, quality, duration and drug prices in rural health institutions to ensure that farmers use safe, effective and cheap drugs. It is necessary to take the implementation of the "food safety project" as the carrier, actively carry out comprehensive health law enforcement supervision, increase supervision over food production, processing, sales and catering industry, and intensify rectification of agricultural inputs such as chemical fertilizers, pesticides, veterinary drugs, feed additives and growth hormones, so as to prevent pollution of agricultural products from the source. Strengthen the construction of food safety standards and inspection and testing systems, and establish county-level comprehensive testing centers for drugs and agricultural products as soon as possible. Fourth, pay more attention to the environmental sanitation rectification work focusing on improving water and toilets. It is necessary to speed up the construction of Hengxi Waterworks, solve the drinking water problems in towns and villages such as Hengxi and Baita as soon as possible, strengthen the construction of tap water pipe network facilities in suburbs, and effectively solve the drinking water quality and safety problems of suburban residents. It is necessary to strengthen the construction of toilets for rural health households, and the construction of public toilets should be adapted to local conditions, giving full play to the role of built public toilets. It is necessary to pay close attention to the construction of county garbage disposal projects and strive to complete and use them as scheduled. Improve the rural garbage disposal facilities, improve the processing capacity, and establish an operation mechanism of urban and rural garbage classification treatment in line with the actual situation of our county. We should attach importance to the construction of rural sewage facilities, give full play to the main role of residents and villagers in rural environmental sanitation rectification, guide the establishment of good hygiene habits, advocate a scientific, civilized and healthy lifestyle, improve rural environmental sanitation and improve the quality of life.

(D) Further increase investment to provide a strong guarantee for rural health development. In strict accordance with the central and provincial policies and regulations on rural health work, we should increase investment in rural health, and the growth rate should not be lower than the growth rate of recurrent fiscal expenditure in the same period. The proportion of health expenditure in fiscal expenditure at the same level has increased year by year. The annual increase in health expenditure is mainly used for developing rural health undertakings, ensuring public health funds such as health supervision, disease prevention and control, maternal and child health care and health education, and rural health service network construction funds. It is necessary to rationally arrange the basic medical service funds of township (center) hospitals and the development and construction funds of rural health undertakings, strengthen the management of rural health funds, and give full play to the efficiency of fund use. It is necessary to give play to the role of the market mechanism, attract social funds to invest in health care through multiple channels, and form an investment system with diversified investment subjects and investment methods.

(5) Further improve the rural cooperative medical system and solve the problem of poverty caused by farmers' illness. First, we should further unify our thinking, effectively improve the understanding of cadres and the masses on the new rural cooperative medical system, carry out extensive and in-depth policy propaganda and typical guidance, improve farmers' awareness of self-protection, mutual assistance and health risks, mobilize farmers' enthusiasm for participating in insurance, improve the participation rate and reduce the economic burden at the village level. Second, seriously study the outstanding problems in the implementation of the new rural cooperative medical system, and strive to improve it from the management system. Problems such as medical reimbursement, procedures, reimbursement quota, participation rate and task index, and the establishment of designated hospitals should be studied and improved. Third, actively do a good job in raising funds for rural medical insurance, form an effective financing mechanism, make good use of and manage rural cooperative medical funds, ensure the orderly operation of cooperative medical funds, give full play to the most effective role of rural cooperative medical care, and improve farmers' health.