湖南省中小学校卫生保健能力现状及改善策略

目的为分析湖南省中小学校卫生保健能力配置现状,改善中小学卫生保健能力提供依据。方法开展学校卫生保健能力建设问卷调查,利用学校卫生工作体系和能力建设调查工作数据采集平台直报数据,对湖南省中小学校卫生保健机构设立以及卫生保健人员配备现状进行分析。结果湖南省12614所中小学校中,3599所寄宿制学校和1704所600人以上非寄宿制学校,至少需配备专职校医9967名,实际仅898名,7311所不足600人非寄宿制学校,专职保健老师仅197名;调查学校中7.3%设置了卫生室,29.6%设置了保健室;7.5%配备了校医,5.3%配备了专职校医,专职校医配备合格率为1.3%;45.6%配备了保健老师,6.6%配备了专职保健老师;90.0%开展了卫生健康相关课程;5.7%的校医和26.5%的保健老师参加过卫生专业技术培训;设置卫生室或保健室、配备(专职)保健老师、配备(专职)校医、开展卫生健康教育、保健老师或校医参加过学校卫生专业知识培训的学校比例,随学龄阶段的上升、经济水平的提高、学校规模的变大,呈逐渐增加趋势(均P<0.001)。结论湖南省中小学校卫生保健机构以及卫生保健人员缺口较大,小于600人的小学卫生保健力量需重视;保健老师和校医学校卫生专业知识培训不足;经济水平仍是影响学校卫生保健机构以及人员配置的关键因素之一。建议通过增加学校卫生工作经费投入,不断完善学校卫生保健机构建立,合理增配学校卫生保健人员,并通过卫生保健人员专业技术培训来提升中小学校卫生保健工作能力。

Status quo of health care capability and its improvement strategy in primary and middle schools in Hunan province

Objective To analyze the status quo of health care capability allocation in primary and middle schools in Hunan province so as to provide a basis for improving health care capability of elementary and secondary schools. Methods We conducted a questionnaire survey on health care capability building in elementary and secondary schools, and then analyzed the status quo of establishment of health care institutions and allocation of health care professionals in elementary and secondary schools in Hunan province by using the directed reported data which came from the data acquisition platform of school health work system and capability building. Results Among 12,614 elementary and secondary schools surveyed in Hunan province, 3,599 boarding schools and 1,704 non-boarding schools with more than 600 students had only 898 full-time school physicians, which lagged behind the basic required numbers of 9,967. There were only 197 full-time health care teachers in 7,311 non-boarding schools with less than 600 students. 7.3% of the surveyed schools set up health clinics, and 29.6% had health care rooms. 7.5% of the surveyed schools wereequipped with school doctors, and only 5.3% with full-time school doctors, reaching a qualified rate of 1.3%. 45.6% ofthe surveyed schools were equipped with health care teachers, and only 6.6% had full-time health care teachers. 90.0% of the surveyed schools provided health-related courses. 5.7% of school doctors and 26.5% of health care teachers had participated in health professional technical training. With the increase of school age, the improvement of local economic level and the enlargement of school scale, theproportions of schools having health clinics or health care rooms, having (full-time) health care teachers, having (full-time) school doctors, providing health courses, and having health care teachers or school doctors participating in school health professional knowledge training showed a gradual upward tendency (all P<0.001). Conclusions There exists a large gap in the number of health care institutions and professionals in the elementary and secondary schools in Hunan province, and special attention should be paid to the health care capability of primary schools with less than 600 students. Health care teachers and school doctors lack health professional knowledge training. Economic level is still one of the key factors affecting health care institutions and allocation of professionals in schools. The results suggest that health care work capability of the elementary and secondary schools can be promoted through increasing the funds for school health work, continuously improving the establishment of school health care institutions, increasing school health care personnel rationally and providing professional technical training for health care personnel.