Community health services and family planning

In India the measures taken by the Community Health Services to eradicate diseases have been largely responsible for the population growth, and the only acceptable way of controlling this population growth is by conception control. The contraceptive methods must be simple, highly acceptable, cheap, preferably nonrepetitive, and reliable. The prerequisite for acceptance of family planning is the sense of security that the children born will live a good life span. Thus, any program designed to control the rate of population growth must include child and maternal health services. Such services were developed in the beginning of the 20th century to provide a standard of prenatal, natal and postnatal care, but the available services do not satisfactorily meet the needs. The Community Health Service has to deal with the following identified health problems in the community if a national population policy is to succeed: 1) care of pregnant women during pregnancy, delivery, and following delivery; 2) motivating and sustaining the motivated couple in contraceptive practice; 3) care of the infant; 4) care of the toddler until 5 years; 5) care of the school age child; 6) care of adolescents; 7) care of tuberculosis and leprosy cases; and, 8) environmental factors. The presence of these problems in the community depend among other factors on the cultural habits, religious beliefs, family traditions, social customs, economic status, and educational level of the population in the community. The present trend is to provide an entire population with at least minimal services; these include elementary health care, health education, and identification of high risk groups who need more than minimal attention. To provide these services a wide network of auxiliaries work closely with professional medical staff as well as with community leaders. It is most important to develop an organizational pattern which considers the available resources and the additional resources that are needed.     

在线健康社区用户个性化及社群化服务研究

目的：优化在线健康社区用户画像模型,全面客观地揭示用户的多维度特征,基于用户画像提出社区用户个性化及社群化服务的建议,提升在线健康社区社会支持服务功能及用户体验。方法：利用模糊逻辑从用户基本属性、社交、兴趣、情感倾向4个维度优化在线健康社区用户画像模型,并对在线健康社区用户进行分类,在“知乎”平台糖尿病话题中选取不同类型用户中的典型用户进行应用研究。结果：根据用户黏性高低、内容贡献量高低、正负情感倾向将3 934名知乎糖尿病话题用户划分为低黏性低产积极、低黏性低产消极、低黏性高产积极等8类用户,每类选取 2 位典型用户用以刻画用户形象;社区运营者可从定期推送社区信息、设计或完善发帖奖励机制、提供情感咨询服务等方面管理社区用户。结论：经过优化的在线健康社区用户画像可准确客观地揭示用户社交行为、兴趣需求、情感倾向等特征,有助于社区运营者提供精准的信息服务和丰富各类社会支持服务,促进社区长久发展。     

上海市社区卫生服务机构基本公共卫生服务均等化工作现状与思考

The promotion of equalization of essential public health services is an important content of our deepening reform of medical and health system.It has an important significance for protecting health equity and improving health level of residents.Three aspects are described for the present situation of equalization of basic public services work in Shanghai community health services facilities as the equalization of basic public health financial investment,the equalization of basic public health resource allocation and the equalization of basic public health supply.The results show that the equalization of Shanghai essential public health services supply is higher and develops in accordance with the national requirement.The basic and the major projects are increased the same time.The indexes of the service amount and service rate are regularly checked.The equalization of basic public health resource allocation is relatively perfect.The community health service centers or sites are complete and the layout is reasonable.They can satisfy the basic public health service demand of residents.The equalization of basic public health financial investment is inadequate.Low financial investment districts depend on the cheap unit labour costs and more work time of the medical staff.Strengthen the execution of policy document and the reasonable allocation of public health talent team is suggested for the relative scarce human resources problem.The clear financial and administrative power and the improvement of the basic public health service evaluation mechanism are suggested for the problem that fiscal investment affects the equalization of basic public health services.This can improve the level of refinement and the entire of the public health service and management.      

社区居民就医意愿与社区卫生服务利用情况调查

采用分层随机抽样方法,对北京市方庄社区10000名居民进行问卷调查,调查居民就医去向、对社区卫生服务项目的利用情况、首诊选择社区的原因等。实际9497名受调查者中去社区卫生服务中心（站）就诊的主要目的是看病（2828例,29．8％）和开药（2677例,28．2％）;居民愿意到社区首诊的原因前三位依次为：就近方便、收费低、解释病情清晰,最后一个原因才是信任医生（3729例,39．3％）。说明居民对社区卫生服务机构的功能认识不足,对社区医生的信任度不高。     

南通市区社区卫生服务反应性调查与分析

目的:了解南通市区当前社区卫生服务机构反应性的现状,为进一步提高反应性提供政策参考。方法:参照WHO卫生系统反应性评价方法,自行设计问卷,随机抽取6所社区卫生服务站的300名患者进行现场拦截调查。结果:南通市区社区卫生服务机构反应性得分为67.03。结论:南通市区社区卫生服务机构反应性处于良好偏下水平,不同人群间具有一定的差异,在反应性的各因素中最需要改进的是:"及时关注"、"维护尊严"和"交流性"3个方面。     

Family planning and public health in Georgia: an enlarged commitment

County clinics reached an estimated 4% of eligible women in 1964 in Georgia. Continuing high crude birth rate showed a large gap between those eligible and interested and those, particularly nonwhites, being served. Although family planning was offered in 133 of 157 counties, the statewide postpartum return rate was only 24% in 1963-4. The maternal mortality rate in Georgia in 1964 was 5.7/10000. Of the 57 maternal deaths, 14 were associated with abortion and 15 with parities of 5 or more. Infant mortality rates were also higher than national figures, 29.2/1000. In November, 1974 State Health Department officials and prominent doctors reorganized the program to offer newer, more modern methods, e.g. oral contraceptives and IUDs, summarized the terms of state subsidization, and enabled clinics to consider systematically all the medical requirements for use of modern methods. Because of cost efficiency and ease of use, the IUD was the mainstay of the program. County acceptance increased steadily since June 1965. By 1966, 96 counties had plans for expanding services. By the end of 1965, 2434 devices were inserted, 832 women accepted oral contraceptives, and 4649 women were using traditional methods.