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本文旨在确认公共支持对预防服务和健康教育覆盖面的影响。对有关6个省 34个县 2 000多农户公共卫生服务获得状况的统计分析表明,在农村预防服务中,儿童免疫项目取得了高覆盖率的成就,但健康教育依然是薄弱环节。在个别低收入地区,由于上级政府的收入再分配和卫生干预行动,实现了较为广泛的公共卫生服务覆盖率。然而,县乡政府的预防支出、村委会提供的补贴和乡卫生院组织的预防活动,对卫生人员开展健康教育还没有形成有效的激励。因此可以设想,改善健康教育现状的起点,应当是变革基层卫生人员的激励机制。
This article aims to confirm the impact of public support on prevention services and health education coverage. A statistical analysis of the access of more than 2,000 rural households to public health services in 34 districts and counties in six provinces shows that children’s immunization programs have achieved high coverage in rural preventive services but health education remains a weak link. In individual low-income areas, a wider coverage of public health services has been achieved due to higher-level government redistribution of income and health interventions. However, prevention expenditures by county and township governments, subsidies provided by village committees, and prevention activities organized by township hospitals have not yet provided effective incentives for health personnel to carry out health education. Therefore, we can imagine that the starting point for improving the status quo of health education should be the incentive mechanism for reforming grassroots health workers.