Semi Structured Interviews

Interviews were conducted with the remaining 15 MCCHS distric directors who were
familiar with the work in the CHS. Interviews were asually carried out in the respondents
work offices.
All participants were informed about the porpuse of the study and were made aware that they
could stop the interview and any point without giving a reason. Written informed consent
and agreement for the use of anonymised qoutes from the interviews were obtained from all
participants.
Semi structured interviews
Semi structured, face to face, tape recorded, qualitative interviews, lasting 60-90 mins, were
conducted by trained professional interviewers from december 2008 to february 2009.
Interviewers to extensive note, in addition to tape recording and transcribing the interviews.
The transcripts were reviewed by the research team. Analysis and interpretation were the
reached by consensus. Using an iterative process in the research team mettings. The research
team was a multidisciplinary group including two community based medical researchers with
qualitative and social research experience, one health administrators from a health bureau
familiar with health policy, one family doctor familiar with the CHS, two epidemiologists and
one master degree candidate with a family medicine degree. The variety of perspetive of the
team ensured a depth of understanding critical to the design of the study and the validity of
the result.
Analysis
Qualitative content analysis (14.15) was used to analyse the data between march 2009 and
may 2009. The data consisted of rich text files containing transcripts of the tape recorded
interviews. The team members read all the material throught several times to obtain a sense
of the whole, and then independently coded transcripts to identify themes by conseding and
summarizing the contents. Coding differences were resolved after throught discussion in
order to ensure that all perspectives on the themes were represented in the written result. The
themes that emerged for the purposes of this report included the content of basic public health
services, funding support, providers and recommendations. All of the interviews were
included in the analysis, there were no diconfirming cases.
Result
Themes from interviews
The findding relate to three main themes, the content of basic public health services, funding
support for basic public health services, and the providers who deliver basic public health
services.
Content of services
Fifteen types of basic public health services, including 78 specific services (apendix 1) were
delivered add different levels in the various districts. Among these services, most of the
directors considered the estabilishment
of health records, chronic disease management,
childhood imunizations and care, maternal care, elderly care, distability and rehabilitations
services, and health educations to be supplied at high levels. However, the provition of
mental health, ophtalmologic, oral health, pest control and andemic disease service were low
and sporadic in some communites due to the low level of staff competency for these tesks
In community health information management, community needs assesment were one of the
importent jobs in the community. The 15 directors agreed that is was often necessary for
community needs assements to be undertaken with the assistance of a special reasearch group
due to paractitioners limited research skills in this area. The rates of creations of paper health
records for all inhabitans were astimated to be high. At present, the goverments have attched
importance to the development of electronic health records, and the transfomation from paper
to electronic records is a slow, stepwise process in the communities
Regarding the management of communicable diseases, most of the CHS organizations roles
are limited to assisting the local CDCs with the completion of tasks such as finding, reporting
and follow-up of cases
The management of chronic, non-communicable diseases is an important job for CHS

organizations because of the high incidence and deleterious effects of these illnesses.
Providing optimal health care for persons with chronic conditions is a major concern in the
community. Beijing municipal health bureau has established a set of guidelines for the
management of chronic diseases in community
Setting including hypertension, diabetes, stroke and heart disease and requires general
practitioners to use these guidelines when managing chronic disease. However, deficiencies
in continuous professional development and lack of evidence based guidelines have created
futher problem in delivering cost effective interventions for chronic disease prevention.
When asked about geriatric care and care of persons with disabilities, all 15 derectors replied
that the instruction of self care and the management of chronic disease were emphasized for
the elderly, and that exercise site have been gradually upgrade by supplying physical
rehabilitation equipment for disable people.
Funding support
An average of 2.38 (at a conversion rate of 10.49RMB to 1) per person per year was
provided for basic public health services in beijing sinces 2008, and each distric government
supplied different amounts of money for basic public health services in its communities
according to its economic level and population. However, basic public health services were
often percieved as not being reimbursed proportionately to the amount of time expended,
particularly when they were opportunistically added to illness visits. The 15 directors
conveyed the opinion that funding for basic public health services was insufficient, and that
most of the funds were spent on correlative public equipment and expendable item.
Provider who deliver basic public health services team consisting mainly of general
practitioners, community nurse and public health specialist deliver basic public health
services in the community. In addtion to supplying medical care, general practitioners are
required to delivery cost free clinical preventive sevices for individuals and families, and
population based public health services (appendix 1). Their roles include being exemplars for
health providing assessements, serving as educators, counsellors and evaluators, and making
referrals when necessary. Public health specialist, who serve as recorders of health data as
well as health educators, are responsible for public health services for population in their
communities. Community nurses mainly assist general practitioners and public health
specialist.

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Interviews were conducted with the remaining 15 MCCHS distric directors who were

of health records, chronic disease management,

The management of chronic, non-communicable diseases is an important job for CHS

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