广西市县级疾控机构“五大卫生”工作的调查与思考  

Survey and reflection on present situation of "Five Healthes" in CDCs of Cities and Countries in Guangxi

作　　者：唐振柱[1] 钟格梅[1] 吕炜[1] 

机构地区：[1]广西壮族自治区疾病预防控制中心,530028

出　　处：《中国公共卫生管理》2008年第5期457-461,共5页Chinese Journal of Public Health Management

摘　　要：目的了解卫生两项体制改革后广西市、县级疾病预防控制中心(CDC)在食品、环境、学校、职业和放射卫生等"五大卫生"方面的人力资源、职能落实情况以及存在的突出问题,为各级卫生行政部门评估和解决这些问题提供科学依据。方法依据调查内容设置相应调查表,以文件形式下发各市、县级CDC进行统一填报。数据处理用Excel2003进行汇总、统计。结果①改革后,市、县CDC在"五大卫生"方面的内设机构和人员配置方面大幅度萎缩,大多数CDC仅设立一个公共卫生科来承担"五大卫生"工作。"五大卫生"技术人员下降严重。②在"五大卫生"诸多职能中,仅在农村饮水卫生监测、食品卫生监测、食品污染事故调查处理和城市饮水卫生监测等履行较好;职业危害因素监测与卫生学评价在市级CDC履行较好,但在县级落实较差,其他许多职能存在比较突出的落实率低甚至没有任何落实的情况,县级CDC放射卫生监测几乎处于瘫痪状态。③市、县级政府财政在"五大卫生"监测与干预方面的财政预算匮乏,有2/3的市级CDC平均每年获得上级或同级财政经费较少,另有1/3的市级CDC无任何专项经费投入。2/3的县级CDC每年获上级或同级财政经费微乎其微,另1/3的县级CDC自成立以来无任何专项经费投入。结论市、县CDC"五大卫生"内设机构配置和人力资源大幅萎缩,工作经费匮乏,卫生监测能力下降。这些问题已严重影响对健康危害因素监测与控制这一CDC的重要职能的落实,"五大卫生"学科发展存在生存危机,必须引起各级政府和卫生行政部门高度重视。Objectives To understand the implemention of human resources arid functions and problems in ＂Five healths＂（i. e. food health, environmental health, occupational health and radiation health） at Guangxi＇s city-and county-level CDCs after the two health systems reform, in order to provide scientific evidence for health authorities to address these issues. Methods Questionnarie data was collected from all of the city and county CDCs, and data analysis was performed using Excel 2003. Results （ 1 ）After the reform, the organizations and personnel in the ＂Five healths＂ had shrunk sharply at those CDCs, most of which only had a public health department to assume the work of the ＂Five healths＂. The average number of professionals had dropped to 12.2 （ 10.83 % ） in cities and 4.2 （ 9.41% ） in counties; （2） Inthe work of the ＂Five healths＂, the monitoring for urban and rural drinking water, food hygiene inspection, and investigation of food poisoning were well performed, with the rates of 93.65 %, 84.13 %, 82.54 % and 79.37 % , respectively. The performance rate of occupational hazard surveillance and health evaluation was 100% at city CDCs wheras only 38.10% and 25.40% at county ones. The radiation health monitoring was nearly paralyzed at county level. （3） The city and county governments were short of funds for the monitoiring and intervention of the ＂Five healths＂.Only 66,67% of the city CDCs received 140,000 RMB annually from the city and above level governments; 33.33% of the city CDCs had no investment of project funds since their establishment. At 62.75 % of the county CDCs, the annual government fund averaged only 7,000 RMB; 37.25% of the county ones had no investment of project funds since their establishment. Conclusion At city and county CDCs, the shrinkage of organizations and personel in the ＂Five healths＂, the lack of funds and decreased capacities have seriously hampered the monitoring and control of health hazards, an important part of CDC＇s responsibilitie

关 键 词：疾病预防控制中心 健康危害因素监测 职能 保障 

分 类 号：R195.4[医药卫生—卫生统计学]