Bridging the Urban- Rural Continuum to Improve Services in Rural China Virginia C. Li, PhD, MPH, Professor of Community Health Sciences UCLA School of Public Health and Songyuan Tang, MB, MPH, MA, Associate professor Lichun Tian, MB, M.P.H., Junior Lecturer Kaining Zhang, M.B., M.S., Professor and Director, Institute for Health Studies and Development, Kunming Medical College, Yunnan, China. Roger Detels, M.D., M.S., is Professor of Epidemiology, UCLA School of Public Health
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Bridging the Urban-Rural Continuum to Improve Services in Rural China Virginia C. Li, PhD, MPH, Professor of Community Health Sciences UCLA School of Public.
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Bridging the Urban-Rural Continuum to Improve Services in
Rural ChinaVirginia C. Li, PhD, MPH,
Professor of Community Health SciencesUCLA School of Public Health
and
Songyuan Tang, MB, MPH, MA, Associate professor
Lichun Tian, MB, M.P.H., Junior Lecturer
Kaining Zhang, M.B., M.S., Professor and Director, Institute for Health Studies and Development, Kunming Medical College, Yunnan, China.
Roger Detels, M.D., M.S., is Professor of Epidemiology, UCLA School of Public Health
Specific Objectives1. Upgrade the quality of family planning and contraceptive
programs, sexually transmitted disease services and services promoting safe motherhood in the rural areas.
2. Disseminate the necessary computer skills to 26 demonstration township health centers through development and evaluation of primary, secondary and tertiary workshops (“train-the-trainers”).
3. Develop a team at IHS to assist township health workers in developing strategies to disseminate the knowledge, strategies and policies from the IHS website to the rural residents.
4. Strengthen capacity for long-term institutional collaboration between IHS and the UCLA School of Public Health Bixby Program to enhance reproductive health research and practice in China.
Figure 1. Dissemination of information from IHSKMC Website to rural health professionals and the other target groups.
服务提供者
Website
Village Doctors/ Teachers/ Women’s Cadres
Villagers/ Students
Figure 2. Website Development, Implementation, and Evaluation.
Site Selection Survey design Identify subjectIdentify core areas
Identify central messages
Develop questionnaires
Finalize pretest Qs
Training interviewers
Field implementation Analysis
Survey organization Supervision
Website Development, Maintenance and Management + Interactivities
Figure 2. Website Development, Implementation, and Evaluation (Cont.).
Eval
uatio
n Su
rvey
Survey design Training interviewers Organize survey team
Implement in fieldsAnalysisReports/papers
Imp
lem
enta
tio
ns
Mobile monitoring team Participatory planning Meeting Trouble shooting
Plan for dissemination of website information, strategies and practices
Tra
inin
g
Training IHS Team
1. Communication and health promotion
2. Strategies for HIV/STD prevention and control in resource-poor and low prevalence settings
3. MCH: Nutrition for mother and infant
Primary target training Secondary target training
1. Overview of Project;2. Role and responsibility;3. Website use and management;4. Computer skills;5. Dissemination Plan;6. Interactive skills; 7. Feedback from field;8. Health education;9. Record keeping of IMS;10. Reporting.
Condoms can protect against HIV infection 33.2 16.4** 50.2 -8.1 41.0 -0.8 <0.0001 0.0004 0.21
HIV can not be transmitted by mosquitoes 20.1 4.2 26.3 -0.6 21.5 5.9 0.28 0.75 0.16
Attitudes toward a HIV infected person 24.3 17.0** 24.6 1.6 32.5 1.5 0.007 0.002 0.95
Hepatitis B can be sexually transmitted 33.2 3.0 32.1 -10.7 33.0 1.5 0.004 0.76 0.01 * Statistically significant difference between baseline and one year follow-up surveys with a P-value less than 0.05. ** Statistically significant difference between baseline and one year follow-up surveys with a P-value less than 0.01.
Table 6. Students knowledge on HIV/AIDS and Hepatitis B in three rural counties, Yunnan, China
Nanhua County Mouding County Dayao County P value of % Change
HIV cannot be transmitted by mosquitoes 13.0 6.7* 11.9 3.7 17.3 -5.2 0.54 0.001 0.008
Hepatitis B can be sexually transmitted 13.0 20.1** 23.3 -6.1 13.3 6.1* <0.0001 0.006 0.001 * Statistically significant difference between baseline and one year follow-up surveys with a P-value less than 0.05. ** Statistically significant difference between baseline and one year follow-up surveys with a P-value less than 0.01.
Conclusion: Using the website for information,
education, and communication in remote area is feasible.
Impact can be achieved even with one computer per agency at the township level.
Logistic support and monitoring is a critical element to success.
There is urgent need for licensing and recertification of village doctors.