General Introduction of General Introduction of Community Health Services in tCommunity Health Services in t

he Hongkou Districthe Hongkou District

Amy Jiang, MPA Shanghai , China

Brief IntroductionBrief Introduction

• Jiang Songyun, Amy Jiang• Bachelor of Preventive Medicine Master of Public Administration (MPA)

Work ExperienceWork Experience

• 1995 ~2005 Shanghai Hongkou District CDC Chief of Infectious Disease and Epidem

iology Branch• Disease outbreak investigations• Analytic epidemiology

Working experienceWorking experience

• 2005 ~present: Health Bureau of Shanghai Hongko

u District , Shanghai, China Vice Director, Department of Publi

c Health

Work ResponsibilitiesWork Responsibilities• Recommend public health policy to the

district government• Implement national, municipal and

district health policy Community Health Service (CHS) emergency response, chronic disease control health education and promotion mental, dental, maternal and child health

care• Supervise, evaluate and oversee quality

of work accomplished by the core operating units

Projects ConductedProjects Conducted• Year 2006

Evaluated the Community Health Service in Hongkou District

Year 2004Developed and implemented immigrant communicable disease control

Year 2002HIV/AIDS community prevention and control program

The Bureau at WorkThe Bureau at Work

Annual district-wide public health conference: attended by the chiefs of all the district departments.

Delivering a lecture on HIV/AIDS prevention and control

A profile of Hongkou district (A profile of Hongkou district (20020055))

• Location: Northeast of downtown• Area: 23.4km2

• 10 communities • Life expectancy : Average: 81.29 Male : 79.44 Female:

83.12• Infant mortality 2.92‰ • Percentage of people over 60 20.80% • Resident people: 789, 000• migration: 150, 000

HongKou District Health Bureau

Core Unit of Public Health in HongKou DistCore Unit of Public Health in HongKou Districtrict

HKCDC

Hygiene supervision

Mental Disease prevention

Dental disease prevention

Maternal and child health care

WHO urban collaborating center

Community health service

& Different level hospital

WHO urban primary health care collaborating center

Established in Oct, 1990 the sole WHO cooperating center in Shanghai

downtown within the research field

General Introduction to a Unique

Characteristic of Hongkou District

Public Health

Entrusted projects of the Entrusted projects of the centercenter

To strengthen self-care capabilities through various health education activities, so as to improve living standard and quality of life;

To study the policies of relevant departments to ensure that health is covered in the policies;

To stress on developing the techniques required for the working staffs involved in urban primary health care;

To provide the technical information related to urban primary health care in order to support the efforts of other cities and the activities planned by the WHO.

Network of Disease Control in Shanghai

Family

DistrictDistrict CDCDistrictDistrict CDCDistrict h healthealth BureauBureau

District h healthealth BureauBureau

Community Health Services

Center

Community Health Services

Center

Municipal GovernmenGovernmen

tt

Municipal GovernmenGovernmen

tt

District District GovernmentGovernment

District District GovernmentGovernment

Municipal Health Bureau

Municipal Health Bureau

Municipal SCDC

Municipal SCDC

Community Community GGovernmentCommunity Community GGovernment

School Enterprise and other Units

——Administrative relationship

……Professional supervision relationship

CHS in China—BackgroundCHS in China—Background• Community-based health care receive much

attention; policies concerned are being developed, should integrate health management for population at community level.

• The change of disease pattern: chronic disease is the main type of disease among people.

• Completed health information is needed to make specific prevention programs and to deliver integrated health service, these information should be collected in the community.

The chief mission of the CHS in ShanThe chief mission of the CHS in ShangHaigHai • Collect basic health information,

and analysis of risk factors and predict trends of disease

• Identify target groups • Deliver convenient , cost-effective

and specific health services to community residents.

CHS work method —step 1CHS work method —step 1

• Collect health record -set up Family

Health File residential status, individual health status (age, sex, income, drinking, smoke, disease,

symptom, health service utilization , etc)

CHS work model—step 2,3CHS work model—step 2,3

• Use health record Stratify general population into

different target group (patient, at risk, healthy) Early detection for certain disease Deliver health service upon their need• Take measure on target

people

Implementation --Implementation --Three level Three level networknetwork

Community health service center: Community mobilization and family in

fom Visit families door by door and intervie

w every member, set up Family Health File

Offer health service to target groups Inner quality control and evaluation

Implementation --Implementation --Three level Three level networknetwork

District CDC Organize implementation Train investigator Establish local multi-sectional

cooperation Site direction and monitoring Quality control and evaluation

Implementation --Implementation --Three level Three level networknetwork Shanghai CDC• Design standard questionary and spe

cific management forms• Develop management guideline• Develop software• Establish multi-sectional cooperation• Management, training, quality control

and assessment

Development of CHS in Hongkou distriDevelopment of CHS in Hongkou districtct

• Three phase• Year 1990-1995 establishment of WHO urban primary health

care collaborating center, building the basic model and team for community health service.

Year 1996-1999 the health promotion project sponsored by

World Bank (7th); progress is continuing Year 2000-now solidify, research, cooperate with

international institutions

Status of CHS in Hongkou distriStatus of CHS in Hongkou districtct

• Already set up a steering committee, gaining strong commitment of the district and local government

• Assign the responsibilities and tasks for related government department

• Put up a work model: government leading, multi-department cooperating, citizen participating• Establish a network, integrating the activities of the

community and government departments• Strengthen research and investigation, providing more

scientific basis for policy-making

Having experienced 15 years of CHS

development, we have achieved great progress by ourselves.

In the year 2005, we gained the honored award of “National District for Community Health Service” which shows that we entered into a new phrase of CHS development.

health education

home service for elder people over 80

health promotion

ChallengeChallenge

• Optimize the CHS working model• Lack of general practitioner (GP)• Strengthen CHS work team

Educational Objectives in Educational Objectives in EHIBEHIB

• To learn public health education as it is practiced in the U.S.

• Attend seminars on other fields within public health

• English language study

The first sight in Asia

Shanghai bund